H43.0 vs S05.2
H43.0 (Vitreous prolapse) compared with S05.2 (Ocular laceration and rupture with prolapse or loss of intraocular tissue), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. H43.0 carries an Excludes1 note covering S05.2: “traumatic vitreous prolapse (S05.2-)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Side by side
| H43.0Vitreous prolapse | S05.2Ocular laceration and rupture with prolapse or loss of intraocular tissue | |
|---|---|---|
| Billing status | Non-billable header | Non-billable header Report instead: S05.20XA, S05.20XD, S05.20XS, S05.21XA, S05.21XD |
| Classification | H00-H59 — Diseases of the Eye and Adnexa (H00-H59) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Vitreous prolapse is a non-billable ICD-10-CM category code (H43.0). | Ocular laceration and rupture with prolapse or loss of intraocular tissue is a non-billable ICD-10-CM category code (S05.2). |
| 7th character | — | The appropriate 7th character is to be added to each code from category S05 |
| Includes | — | open wound of eye and orbit injuries of ear injuries of eye injuries of face [any part] |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources