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H40.2221 vs H40.223

H40.2221 (Chronic angle-closure glaucoma, left eye, mild stage) compared with H40.223 (Chronic angle-closure glaucoma, bilateral), from the official CMS tabular data.

Summary

These codes name the same condition on opposite sides of the body, so the documented side decides which one applies.

MedCoder-derived
What is different?

Title wording and billing status.The titles share “Chronic angle-closure glaucoma”; H40.2221 says “left eye, mild stage” where H40.223 says “bilateral”. H40.223 is a non-billable header; H40.2221 is billable.

Registry fact

Can these codes be reported together?

One side per condition.H40.2221 and H40.223 name the same condition on opposite sides of the body. Same category and title, differing only in which side is affected — the documentation decides which one applies, and a bilateral code is reported only where the code set provides one.

MedCoder-derivedGuide: Laterality coding

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. H40.2221 carries 5 Excludes1 notes and H40.223 carries 5 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?

No.Neither is a subdivision of the other, and neither title is the unspecified form; they describe different conditions within category H40.

Registry fact

Is one a parent or header code?

One is a header.H40.223 is a non-billable header, but H40.2221 is not one of its subdivisions.

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?

Yes.Same condition, opposite side. H40.2221 and H40.223 name the same condition on opposite sides of the body.

MedCoder-derivedGuide: Laterality coding

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?

Review

Laterality relationship

H40.2221
Left
Chronic angle-closure glaucoma, left eye, mild stage
↔
H40.223
Bilateral
Chronic angle-closure glaucoma, bilateral

What we found

Same condition, opposite side.H40.2221 and H40.223 name the same condition on opposite sides of the body.

Same category and title, differing only in which side is affected — the documentation decides which one applies, and a bilateral code is reported only where the code set provides one.

What to review

Report the side the documentation names. Where the code set provides a bilateral code and both sides are documented, use it instead of the pair.

Guide: Laterality codingCheck these on a claim

Why it matters

These codes share a category and title and differ only in the side affected. The documentation decides which applies, and a bilateral code is reported only where the code set provides one.

Source / rule

ICD-10-CM tabular list (laterality variant derived from the code title)

Official guidance behind these answers

  • Section I.B.13 — Laterality · applies to: Laterality

    Some ICD-10-CM codes indicate laterality, specifying whether the condition occurs on the left, right or is bilateral. If no bilateral code is provided and the condition is bilateral, assign separate codes for both the left and right side. If the side is not identified in the medical record, assign the code for the unspecified side. When a patient has a bilateral condition and each side is treated during separate encounters, assign the "bilateral" code (as the condition still exists on both sides), including for the encounter to treat the first side. For the second encounter for treatment after one side has previously been treated and the condition no longer exists on that side, assign the appropriate unilateral code for the side where the condition still exists (e.g., cataract surgery performed on each eye in separate encounters). The bilateral code would not be assigned for the subsequent encounter, as the patient no longer has the condition in the previously-treated site. If the treatment on the first side did not completely resolve the condition, then the bilateral code would still be appropriate. When laterality is not documented by the patient’s provider, code assignment for the affected side may be based on medical record documentation from other clinicians. If there is conflicting medical record documentation regarding the affected side, the patient’s provider should be queried for clarification. […]

    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

H40.2221Chronic angle-closure glaucoma, left eye, mild stageH40.223Chronic angle-closure glaucoma, bilateral
Billing statusBillableNon-billable header

Report instead: H40.2230, H40.2231, H40.2232, H40.2233, H40.2234

ClassificationH00-H59 — Diseases of the Eye and Adnexa (H00-H59)H00-H59 — Diseases of the Eye and Adnexa (H00-H59)
DefinitionChronic angle-closure glaucoma, left eye, mild stage is a billable ICD-10-CM diagnosis code (H40.2221).Chronic angle-closure glaucoma, bilateral is a non-billable ICD-10-CM category code (H40.223).
7th characterOne of the following 7th characters is to be assigned to each code in subcategory H40.22 to designate the stage of glaucomaOne of the following 7th characters is to be assigned to each code in subcategory H40.22 to designate the stage of glaucoma
Excludes1
aqueous misdirection (H40.83-)
malignant glaucoma (H40.83-)
absolute glaucoma (H44.51-)
congenital glaucoma (Q15.0)
traumatic glaucoma due to birth injury (P15.3)
aqueous misdirection (H40.83-)
malignant glaucoma (H40.83-)
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.

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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