Valid for Submission
H26.003 is a billable diagnosis code used to specify a medical diagnosis of unspecified infantile and juvenile cataract, bilateral. The code H26.003 is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.
The ICD-10-CM code H26.003 might also be used to specify conditions or terms like bilateral cataracts, cataract of lens capsule of bilateral eyes, cataract of lens capsule of left eye, cataract of lens capsule of right eye, presenile cataract , presenile cataract of bilateral eyes, etc.
The code H26.003 is applicable for patients aged 0 through 17 years inclusive. It is clinically and virtually impossible to use this code on a patient outside the stated age range.
Unspecified diagnosis codes like H26.003 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Bilateral cataracts
- Cataract of lens capsule of bilateral eyes
- Cataract of lens capsule of left eye
- Cataract of lens capsule of right eye
- Presenile cataract
- Presenile cataract of bilateral eyes
- Presenile cataract of left eye
- Presenile cataract of right eye
- Total cataract of lens of bilateral eyes
- Total cataract of lens of left eye
- Total cataract of lens of right eye
Diagnostic Related Groups - MS-DRG Mapping
|MS-DRG||MS-DRG Title||MCD||Relative Weight|
|124||OTHER DISORDERS OF THE EYE WITH MCC||02||1.3988|
|125||OTHER DISORDERS OF THE EYE WITHOUT MCC||02||0.8354|
The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.
Convert H26.003 to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code H26.003 its ICD-9 equivalent. The approximate mapping means there is not an exact match between the ICD-10 code and the ICD-9 code and the mapped code is not a precise representation of the original code.
Information for Patients
A cataract is a clouding of the lens in your eye. It affects your vision. Cataracts are very common in older people. By age 80, more than half of all Americans either have a cataract or have had cataract surgery.
A cataract can occur in either or both eyes. It cannot spread from one eye to the other. Common symptoms are
- Blurry vision
- Colors that seem faded
- Glare - headlights, lamps or sunlight may seem too bright. You may also see a halo around lights.
- Not being able to see well at night
- Double vision
- Frequent prescription changes in your eye wear
Cataracts usually develop slowly. New glasses, brighter lighting, anti-glare sunglasses or magnifying lenses can help at first. Surgery is also an option. It involves removing the cloudy lens and replacing it with an artificial lens. Wearing sunglasses and a hat with a brim to block ultraviolet sunlight may help to delay cataracts.
NIH: National Eye Institute
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