H40.113 vs H40.1131
H40.113 (Primary open-angle glaucoma, bilateral) compared with H40.1131 (Primary open-angle glaucoma, bilateral, mild stage), from the official CMS tabular data.
Summary
These codes represent different levels of the same hierarchy: H40.113 is the non-billable header that contains H40.1131, so only H40.1131 (or a sibling) is reported.
Registry fact- What is different?
Title wording and billing status.H40.1131’s title adds “mild stage” to the wording the two share (“Primary open-angle glaucoma, bilateral”). H40.113 is a non-billable header; H40.1131 is billable.
Registry fact
- Can these codes be reported together?
Not as a pair.H40.113 is the non-billable header that contains H40.1131. A header is not reported on a claim, so the choice is H40.1131 or a sibling that matches the documentation.
Registry fact
- Is there an Excludes1 relationship?
None.Neither entry carries an Excludes1 note that names the other code. H40.113 carries 3 Excludes1 notes and H40.1131 carries 3 Excludes1 notes covering other codes; the side-by-side table quotes them.
Official rule
- Is there an Excludes2 relationship?
None.Neither entry carries an Excludes2 note that names the other code.
Official rule
- Is one more specific?
Yes.H40.1131 is a subdivision of H40.113 in the tabular hierarchy, so it is the more specific of the two.
Registry fact
- Is one a parent or header code?
Yes.H40.113 is the non-billable header that contains H40.1131. A header stands for the whole family beneath it and is not reported on a claim.
Registry fact
- Are there sequencing instructions?
None.Neither entry carries a Code First or Use Additional Code note that names the other.
Official rule
- Are there other coding relationships?
None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.
MedCoder-derived
Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels
Can these codes be reported together?
Not as a pair — H40.113 is not reportable. H40.113 is the non-billable category that contains H40.1131.
A header stands for the whole family of codes beneath it and is not reported on a claim, so the choice is H40.1131 or a sibling that matches the documentation. No Excludes1/Excludes2 relationship exists between these codes in the official tabular list.
Official guidance behind these answers
Section I.B.2 — Level of Detail in Coding · applies to: H40.113 and H40.1131
Diagnosis codes are to be used and reported at their highest number of characters available and to the highest level of specificity documented in the medical record. ICD-10-CM diagnosis codes are composed of codes with 3, 4, 5, 6 or 7 characters. Codes with three characters are included in ICD-10-CM as the heading of a category of codes that may be further subdivided by the use of fourth and/or fifth characters and/or sixth characters, which provide greater detail. A three-character code is to be used only if it is not further subdivided. A code is invalid if it has not been coded to the full number of characters required for that code, including the 7th character, if applicable.
ICD-10-CM Official Guidelines FY2026
Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum
Side by side
| H40.113Primary open-angle glaucoma, bilateral | H40.1131Primary open-angle glaucoma, bilateral, mild stage | |
|---|---|---|
| Billing status | Non-billable header Report instead: H40.1130, H40.1131, H40.1132, H40.1133, H40.1134 | Billable |
| Classification | H00-H59 — Diseases of the Eye and Adnexa (H00-H59) | H00-H59 — Diseases of the Eye and Adnexa (H00-H59) |
| Definition | Primary open-angle glaucoma, bilateral is a non-billable ICD-10-CM category code (H40.113). | Primary open-angle glaucoma, bilateral, mild stage is a billable ICD-10-CM diagnosis code (H40.1131). |
| 7th character | One of the following 7th characters is to be assigned to each code in subcategory H40.11 to designate the stage of glaucoma | One of the following 7th characters is to be assigned to each code in subcategory H40.11 to designate the stage of glaucoma |
| Excludes1 | absolute glaucoma (H44.51-) congenital glaucoma (Q15.0) traumatic glaucoma due to birth injury (P15.3) | absolute glaucoma (H44.51-) congenital glaucoma (Q15.0) traumatic glaucoma due to birth injury (P15.3) |
Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.
Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources