2027 ICD-10-CM Diagnosis Code Z98.42Cataract extraction status, left eye
Z98.42 is a billable ICD-10-CM diagnosis code for cataract extraction status, left eye. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 951. The code is not accepted as a principal diagnosis by the Medicare Code Editor and exempt from POA reporting. Coders also document this condition as history of bilateral cataract extraction. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Implant, device or graft related encounter.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z98.42.
Present on Admission (POA)Billing
Z98.42 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99).
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- History of bilateral cataract extraction
- History of cataract extraction
- History of left cataract extraction
- History of right cataract extraction
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z98.42: its own notes plus those printed at Z98.4, Z98, block Z77-Z99, and Chapter 21. 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.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
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.
- Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
- (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
- (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name Z98.42, its category, or a range that includes it.
Excludes1 1
These codes carry an Excludes1 note naming Z98.42: they are not reported together with it, unless the two conditions are unrelated.
Excludes2 2
These codes carry an Excludes2 note naming Z98.42: its condition is not part of those codes, and both may be reported when the patient has both.
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 Z98.42 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z98.42Overview
What is the ICD-10 code for cataract extraction status, left eye?
The ICD-10-CM code for cataract extraction status, left eye is Z98.42 (sometimes written as Z9842). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Z98.42 (Cataract extraction status) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report cataract extraction status, left eye on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z98.42 group to?
On inpatient claims, cataract extraction status, left eye maps to MS-DRG 951 (other Factors Influencing Health Status), which carries a relative weight of 0.5574. Higher weights mean higher Medicare reimbursement.
Can Z98.42 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because cataract extraction status, left eye describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z98.42 exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for cataract extraction status, left eye on inpatient claims. The code appears in the Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99) range of the CMS exempt list.
