2026 ICD-10-CM Diagnosis Code H26.043Anterior subcapsular polar infantile and juvenile cataract, bilateral

ICD-10-CM Codes›H00–H59›H25-H28›H26

ICD-10-CM H26.043
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

H26.043 is a billable ICD-10-CM diagnosis code for anterior subcapsular polar infantile and juvenile cataract, bilateral. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 124 through 125. The code is restricted by the Medicare Code Editor to pediatric patients (age 0 through 17). Coders also document this condition as anterior subcapsular cataract of bilateral eyes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Cataract and other lens disorders.

Code Identity

ICD-10-CM Code
H26.043
Billable Status
Yes — Valid for Submission
Code Describes
Anterior subcapsular polar infantile and juvenile cataract, bilateral
Short Description
Ant subcapsular polar infantile and juvenile cataract, bi
Parent Code
H26.04
Anterior subcapsular polar infantile and juvenile cataract

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH25-H28Disorders of lens
CategoryH26Other cataract
This CodeH26.043Anterior subcapsular polar infantile and juvenile cataract, bilateral

Code EditsBilling

Medicare Code Editor checks that affect claim validity for H26.043.

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).

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Anterior subcapsular cataract of bilateral eyes
  • Anterior subcapsular cataract of left eye
  • Anterior subcapsular cataract of right eye

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR EYE002
Cataract and other lens disorders
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

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.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert H26.043 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
366.01 Ant subcaps pol cataract
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About H26.043Overview

Is H26.043 (Anterior subcapsular polar infantile and juvenile cataract) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report anterior subcapsular polar infantile and juvenile cataract, bilateral on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does H26.043 group to?

When anterior subcapsular polar infantile and juvenile cataract, bilateral is the principal diagnosis on an inpatient stay, it groups to MS-DRG 124, 125, with relative weights from 0.7678 to 1.3231 depending on complications. Higher weights mean higher Medicare reimbursement.

Who can H26.043 be reported for?

The Medicare Code Editor checks anterior subcapsular polar infantile and juvenile cataract, bilateral against patient demographics: this code is intended for pediatric patients (age 0 through 17). Claims outside these limits are flagged as inconsistent.

What is the ICD-9 equivalent of H26.043?

Under the General Equivalence Mappings, anterior subcapsular polar infantile and juvenile cataract, bilateral converts to ICD-9-CM 366.01 (ant subcaps pol cataract). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.