2024 ICD-10-CM Diagnosis Code H26.009

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

• Anterior capsular lens opacities
• Anterior lens opacities
• Anterior subcapsular lens opacities
• Cataract
• Cataract maturity - finding
• Cataract present
• Cataract, growth hormone deficiency, sensory neuropathy, sensorineural hearing loss, skeletal dysplasia syndrome
• Cataract, growth hormone deficiency, sensory neuropathy, sensorineural hearing loss, skeletal dysplasia syndrome
• Congenital anomaly of macula
• Congenital hypoplasia of fovea centralis
• Congenital muscular dystrophy with infantile cataract and hypogonadism syndrome
• Congenital nystagmus
• Cortical lens opacities
• Cupuliform cataract
• Early opacity of lens
• Familial renal glucosuria
• Foveal hypoplasia with presenile cataract syndrome
• Hereditary growth hormone deficiency
• Hereditary growth hormone deficiency
• Hereditary sensory neuropathy
• Hereditary sensory neuropathy
• Infantile and/or juvenile cataract
• Infantile and/or juvenile cataract
• Infantile and/or juvenile cataract
• Infantile and/or juvenile cataract
• Infantile cataract
• Infantile cataract
• Interlenticular opacification
• Juvenile cataract
• Juvenile cataract
• Juvenile cataract
• Juvenile cataract, microcornea, renal glucosuria syndrome
• Microcornea
• Microcornea, rod-cone dystrophy, cataract, posterior staphyloma syndrome
• Nonsenile cataract
• Nonsenile cataract
• Nonsenile cataract
• Presenile cataract
• Presenile cataract
• Renal glycosuria
• Retinitis pigmentosa, juvenile cataract, short stature, intellectual disability syndrome
• Sensory neuropathy
• Sensory neuropathy
• Spontaneous reabsorption of cataract

Clinical Information

• Capsule Opacification

  clouding or loss of transparency of the posterior lens capsule, usually following cataract extraction.

• Cataract

  partial or complete opacity on or in the lens or capsule of one or both eyes, impairing vision or causing blindness. the many kinds of cataract are classified by their morphology (size, shape, location) or etiology (cause and time of occurrence). (dorland, 27th ed)

• Cataract Extraction

  the removal of a cataractous crystalline lens from the eye.

• Microcornea

  a congenital abnormality characterized by an abnormally small cornea. the horizontal corneal diameter is less than 10mm or less than 9mm in newborns. it is associated with an increased risk of glaucoma.

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

• Pediatric diagnoses - The Medicare Code Editor detects inconsistencies in pediatric cases by checking a patient's age and any diagnosis on the patient's record. The pediatric code edits apply to patients age range is 0–17 years inclusive (e.g., Reye's syndrome, routine child health exam).

H26.009 is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
124	OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT	02	1.3219
125	OTHER DISORDERS OF THE EYE WITHOUT MCC	02	0.7975

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 H26.009 to ICD-9-CM

• ICD-9-CM Code: 366.00 - Nonsenile cataract NOS
  Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education

Cataract

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

[Learn More in MedlinePlus]

Code History

• FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.