2027 ICD-10-CM Diagnosis Code H26.213Cataract with neovascularization, bilateral
ICD-10-CM Codes›H00–H59›H25-H28›H26
- Billable — Valid for Submission
- Chronic Condition
H26.213 is a billable ICD-10-CM diagnosis code for cataract with neovascularization, bilateral. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 124 through 125. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Cataract and other lens disorders.
Code Identity
Code Classification
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to H26.213: its own notes plus those printed at H26.21, H26, and Chapter 7. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury (trauma) of eye and orbit (S05.-)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
- syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
Notes
General instructions on how these codes are used.
- Use an external cause code following the code for the eye condition, if applicable, to identify the cause of the eye condition
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name H26.213, its category, or a range that includes it.
Use Additional Code 1
These codes say to use an additional code from the note, and H26.213 is one of the codes named.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Cataract
A cataract is a clouding of the clear lens inside your eye. This cloudiness blocks light from reaching the back of the eye, making it harder to see clearly. A cataract can affect one or both eyes, but it doesn't spread from one eye to the other.
The full article covers:
- What are cataracts?
- What causes cataracts?
- Who is more likely to develop cataracts?
- What are the symptoms of cataracts?
- How are cataracts diagnosed?
- How are cataracts treated?
- Can cataracts be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert H26.213 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About H26.213Overview
What is the ICD-10 code for cataract with neovascularization, bilateral?
The ICD-10-CM code for cataract with neovascularization, bilateral is H26.213 (sometimes written as H26213). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is H26.213 (Cataract with neovascularization) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report cataract with neovascularization, bilateral on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does H26.213 group to?
When cataract with neovascularization, bilateral is the principal diagnosis on an inpatient stay, it groups to MS-DRG 125, 124, with relative weights from 0.7699 to 1.2470 depending on complications. Higher weights mean higher Medicare reimbursement.
Can H26.213 be reported with Q12.0?
Not as a rule. The Excludes1 note at H26, which applies to H26.213, lists "congenital cataract (Q12.0)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
What is the ICD-9 equivalent of H26.213?
Under the General Equivalence Mappings, cataract with neovascularization, bilateral converts to ICD-9-CM 366.33 (cataract w neovasculizat). The mapping is approximate, so confirm the match fits the documentation.
