2026 ICD-10-CM Diagnosis Code H40.1194Primary open-angle glaucoma, unspecified eye, indeterminate stage

ICD-10-CM Codes›H00–H59›H40-H42›H40

ICD-10-CM H40.1194
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

H40.1194 is a billable ICD-10-CM diagnosis code for primary open-angle glaucoma, unspecified eye, indeterminate stage. The 7th character 4 reports glaucoma whose stage cannot be clinically determined. 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. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Glaucoma.

Code Identity

ICD-10-CM Code
H40.1194
Billable Status
Yes — Valid for Submission
Code Describes
Primary open-angle glaucoma, unspecified eye, indeterminate stage
Short Description
Primary open-angle glaucoma, unsp, indeterminate stage
Parent Code
H40.119
Primary open-angle glaucoma, unspecified eye

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH40-H42Glaucoma
CategoryH40Glaucoma
This CodeH40.1194Primary open-angle glaucoma, unspecified eye, indeterminate stage

Clinical ClassificationClinical

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

CCSR EYE003
Glaucoma
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Glaucoma

Glaucoma is a group of diseases that can damage the optic nerve of one, or both, of your eyes. This can result in vision loss. There are different types of glaucoma, but the most common type is open-angle glaucoma. Other less common types include angle-closure glaucoma, and congenital glaucoma.

The full article covers:

  • What is glaucoma?
  • What causes glaucoma?
  • What are the symptoms of glaucoma?
  • How is glaucoma diagnosed?
  • What are the treatments for glaucoma?
  • Can glaucoma be prevented?

Read the full article at MedlinePlus

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

Convert H40.1194 to ICD-9-CMHistory

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

ICD-9-CM
365.11 Prim open angle glaucoma
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.
ICD-9-CM
365.74 Indeterm stage glaucoma
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.

Code History & ChangesHistory

Replacement H40.1194 replaces the following previously assigned code(s):

  • H40.11X4 - Primary open-angle glaucoma, indeterminate stage
FY 2018AddedAdded to the ICD-10-CM code setEffective October 1, 2017.
FY 2019–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About H40.1194Overview

Is H40.1194 (Primary open-angle glaucoma, unspecified eye) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report primary open-angle glaucoma, unspecified eye, indeterminate stage on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character 4 in H40.1194 mean?

The final character 4 reports glaucoma whose stage cannot be clinically determined, in this case involving the primary open-angle glaucoma.

What MS-DRG does H40.1194 group to?

When primary open-angle glaucoma, unspecified eye, indeterminate stage 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.

What is the ICD-9 equivalent of H40.1194?

Under the General Equivalence Mappings, primary open-angle glaucoma, unspecified eye, indeterminate stage converts to ICD-9-CM 365.11 (prim open angle glaucoma) and 365.74 (indeterm stage glaucoma). 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.