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Home/Diagnosis/ICD-10 Coding for Posterior Capsular Opacification

ICD-10 Coding for Posterior Capsular Opacification

H26.41
H26.42
H26.499

Complete ICD-10-CM coding and documentation guide for icd-10 coding for posterior capsular opacification includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Secondary Cataract
PCO
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Key Information: ICD-10 Coding for Posterior Capsular Opacification

Essential facts and insights about ICD-10 Coding for Posterior Capsular Opacification

Use ICD-10 code H26.41 for secondary cataract, right eye, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Secondary cataract, right eye

Non-Billable
H26.41
Non-Billable

Diagnostic Criteria

  • • Documented best corrected visual acuity (BCVA) of 20/30 or worse
  • • Retroillumination images showing opacification
  • • Impact on activities of daily living (ADLs)

Applicable To

  • • Posterior capsular opacification, right eye

Important Notes

  • • Ensure laterality is documented to avoid unspecified coding.

Secondary cataract, left eye

Non-Billable
H26.42
Non-Billable

Diagnostic Criteria

Ancillary Codes

Additional codes that may be used with this diagnosis

92012

Intermediate ophthalmological exam

Use for pre-procedure evaluation of PCO.

76514

Ophthalmic ultrasound, diagnostic

Use if posterior segment evaluation is needed.

Frequently Asked Questions

What is the ICD-10 code for posterior capsular opacification?

The ICD-10 code for posterior capsular opacification is H26.41 for the right eye and H26.42 for the left eye.

How is posterior capsular opacification treated?

Posterior capsular opacification is typically treated with a YAG laser capsulotomy, coded as 66821.

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  • • Documented best corrected visual acuity (BCVA) of 20/30 or worse
  • • Retroillumination images showing opacification
  • • Impact on activities of daily living (ADLs)

Applicable To

  • • Posterior capsular opacification, left eye

Important Notes

  • • Ensure laterality is documented to avoid unspecified coding.

Other secondary cataract, unspecified eye

Billable Code
H26.499
Billable

Diagnostic Criteria

  • • Documented visual impairment due to PCO without specified laterality

Applicable To

  • • Posterior capsular opacification, unspecified eye

Important Notes

  • • Avoid using this code if laterality can be determined.