2027 ICD-10-CM Diagnosis Code H40.20X3Unspecified primary angle-closure glaucoma, severe stage
ICD-10-CM Codes›H00–H59›H40-H42›H40
- Billable — Valid for Submission
- 7th Character 3 — Severe Stage
- Chronic Condition
H40.20X3 is a billable ICD-10-CM diagnosis code for unspecified primary angle-closure glaucoma, severe stage. The 7th character 3 means severe stage. 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 Glaucoma.
H40.20X3 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 243 and RxHCC Part D (V08) category 244 for payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
H40.20X3 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model, but it maps to payment categories in the other CMS models shown below.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to H40.20X3: its own notes plus those printed at H40.20, H40.2, H40, 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)
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
7th Character
Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.
- One of the following 7th characters is to be assigned to code H40.20 to designate the stage of glaucoma
- 0stage unspecified
- 1mild stage
- 2moderate stage
- 3severe stage this code
- 4indeterminate stage
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Glaucoma
an ocular disease, occurring in many forms, having as its primary characteristics an unstable or a sustained increase in the intraocular pressure which the eye cannot withstand without damage to its structure or impairment of its function. the consequences of the increased pressure may be manifested in a variety of symptoms, depending upon type and severity, such as excavation of the optic disk, hardness of the eyeball, corneal anesthesia, reduced visual acuity, seeing of colored halos around lights, disturbed dark adaptation, visual field defects, and headaches. (dictionary of visual science, 4th ed)
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 H40.20X3 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About H40.20X3Overview
What is the ICD-10 code for unspecified primary angle-closure glaucoma, severe stage?
The ICD-10-CM code for unspecified primary angle-closure glaucoma, severe stage is H40.20X3 (sometimes written as H4020X3). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is H40.20X3 (Unspecified primary angle-closure glaucoma) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report unspecified primary angle-closure glaucoma, severe stage on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character 3 in H40.20X3 mean?
The final character 3 means severe stage, in this case for the unspecified primary angle-closure glaucoma. It comes from the 7th character list in the CMS Tabular List for this category.
What MS-DRG does H40.20X3 group to?
When unspecified primary angle-closure glaucoma, severe stage 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 H40.20X3 be reported with a code from H40.83?
Not as a rule. The Excludes1 note at H40.2, which applies to H40.20X3, lists "aqueous misdirection (H40.83-)". 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).
Does H40.20X3 risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage: H40.20X3 maps to no category in the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 243 (Glaucoma, Open-Angle or Moderate/Severe Stage) and RxHCC Part D (V08) category 244 (Other Non-Acute Glaucoma).
