2027 ICD-10-CM Diagnosis Code H40.813Glaucoma with increased episcleral venous pressure, bilateral

ICD-10-CM Codes›H00–H59›H40-H42›H40

ICD-10-CM H40.813
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

H40.813 is a billable ICD-10-CM diagnosis code for glaucoma with increased episcleral venous pressure, 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. Coders also document this condition as bilateral glaucoma of eyes due to increased episcleral venous pressure. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Glaucoma.

H40.813 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 244 for payment year 2027.

Code Identity

ICD-10-CM Code
H40.813
Billable Status
Yes — Valid for Submission
Code Describes
Glaucoma with increased episcleral venous pressure, bilateral
Short Description
Glaucoma w increased episcleral venous pressure, bilateral
Parent Code
H40.81
Glaucoma with increased episcleral venous pressure

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH40-H42Glaucoma
CategoryH40Glaucoma
This CodeH40.813Glaucoma with increased episcleral venous pressure, bilateral

Medicare Risk Adjustment (HCC)Billing

H40.813 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.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
no payment category in the model that pays 100% of MA risk scores
Prior Model (CMS-HCC V24)
Not mapped under V24
this diagnosis newly risk-adjusts under the V28 model
Part D (RxHCC)
RxHCC 244 — Other Non-Acute Glaucoma
also risk-adjusts in the Part D prescription drug model (V08)

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.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Bilateral glaucoma of eyes due to increased episcleral venous pressure
  • Glaucoma of left eye due to increased episcleral venous pressure
  • Glaucoma of right eye due to increased episcleral venous pressure
  • Glaucoma with increased episcleral venous pressure

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to H40.813: its own notes plus those printed at 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.

From H40 Glaucoma applies to 252 codes
  • absolute glaucoma (H44.51-)
  • congenital glaucoma (Q15.0)
  • traumatic glaucoma due to birth injury (P15.3)

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.

From Chapter 7 (H00-H59) Diseases of the eye and adnexa applies to 2,677 codes
  • 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.

From Chapter 7 (H00-H59) Diseases of the eye and adnexa applies to 2,677 codes
  • 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.

Clinical ClassificationClinical

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

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

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 H40.813 to ICD-9-CMHistory

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

ICD-9-CM
365.82 Glauc w inc episcl press
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 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About H40.813Overview

What is the ICD-10 code for glaucoma with increased episcleral venous pressure, bilateral?

The ICD-10-CM code for glaucoma with increased episcleral venous pressure, bilateral is H40.813 (sometimes written as H40813). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is H40.813 (Glaucoma with increased episcleral venous pressure) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report glaucoma with increased episcleral venous pressure, bilateral on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does H40.813 group to?

When glaucoma with increased episcleral venous pressure, 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 H40.813 be reported with a code from H44.51?

Not as a rule. The Excludes1 note at H40, which applies to H40.813, lists "absolute glaucoma (H44.51-)". 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 H40.813?

Under the General Equivalence Mappings, glaucoma with increased episcleral venous pressure, bilateral converts to ICD-9-CM 365.82 (glauc w inc episcl press). The mapping is approximate, so confirm the match fits the documentation.

Does H40.813 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage: H40.813 maps to no category in the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 244 (Other Non-Acute Glaucoma).