H59.4 (Inflammation (infection) of postprocedural bleb) compared with T81.49XA (Infection following a procedure, other surgical site, initial encounter), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Distinct conditions — both may be reported.
“bleb associated endophthalmitis (H59.4-)”
An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.
Source: CMS ICD-10-CM tabular instructional notes
Yes, when both are documented. T81.49XA carries an Excludes2 note covering H59.4: “bleb associated endophthalmitis (H59.4-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
| H59.4Inflammation (infection) of postprocedural bleb | T81.49XAInfection following a procedure, other surgical site, initial encounter | |
|---|---|---|
| Billing status | Non-billable header | Billable |
| 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 | Inflammation (infection) of postprocedural bleb is a non-billable ICD-10-CM category code (H59.4). | Infection following a procedure, other surgical site, initial encounter is a billable ICD-10-CM diagnosis code (T81.49A). |
| 7th character | — | The appropriate 7th character is to be added to each code from category T81 |
| Includes | Postprocedural blebitis | — |
| Use additional code | — | code to identify infection code (R65.2-) to identify severe sepsis, if applicable code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources