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H01.8A ICD-10-CM Code: Other specified inflammation of right eye, upper and lower eyelids

Compare with another code for H01.8ACheck this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
2 Excludes2 · 1 code-also instruction

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

Code alsofrom H01.8May be needed with this code
  • Code also, if applicable, infestation by Demodex mites (B88.01)
Excludes2from H00-H05Not included here; may be reported together

Where it sits Source: CMS/NCHS

Under:Chapter 7: Diseases of the Eye and AdnexaH00-H05 Disorders of eyelid, lacrimal system and orbitH01 Other inflammation of eyelidH01.8 Other specified inflammations of eyelid

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 124 — OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT (MDC 02)
  • MS-DRG 125 — OTHER DISORDERS OF THE EYE WITHOUT MCC (MDC 02)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for H01.8A in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on H01.8A itself; “inherited from” names the category or block whose note applies here.

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from H00-H05

Code Also

Additional codes that may be required to fully describe the encounter.

  • Code also, if applicable, infestation by Demodex mites (B88.01)

Source: inherited from H01.8

Coder workflow for H01.8A

MedCoder structured workflow — derived from this code’s own official record

Before you code H01.8A

  1. “Other” (NEC) means the condition is specified in the record but no dedicated code captures it. Confirm the documented form is not one a sibling code names before settling on H01.8A; if the record states no specifics at all, the unspecified sibling applies instead. “Other” codes are for documented conditions the classification gives no specific code; “unspecified” codes are for records lacking the detail (Guidelines I.A.9.a, I.A.9.b).

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

  2. Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: right). The unspecified-side code applies only when the record states no side. Laterality is assigned from the documented side; where a bilateral code exists and both sides are documented, it is used instead of two unilateral codes (Guidelines I.B.13).

    ReviewH01.8B · left

    Guide: Laterality coding →

Choose the right path

  1. Is the side documented?
    Yes → Select the code for the documented side (or the bilateral code when both sides are documented and one exists).
    No → Use the unspecified-side code only when the record states no side; a query is the alternative.

    ReviewH01.8B · left

Consider H01.8A. Then review the Code Also note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Laterality
Right, left or bilateral as documented; unspecified only when the record states no side (Guidelines I.B.13).
Any detail beyond this code’s title
What the record states that a more specific code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

  • Excludes2 — not part of H01.8A(2 notes)

    Coding workflow: The conditions named in this note are not included in H01.8A. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareS01.1, S00.1, S00.2

    See the official tabular notes · Guidelines I.A.12.b

  • Code Also — related condition(1 note)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    ReviewB88.01

    See the official tabular notes · Guidelines I.A.17

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: The record documents the condition on one side only.

Coding question: Which code in this family applies?

Path: Select the sibling code for the documented side.

Reason: Laterality is assigned from the documented side; the unspecified-side code is for records that state no side (Guidelines I.B.13).

ReviewH01.8B · left

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse H01.8A with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of H01.8A — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • H01.83— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Other specified inflammation of right eye, unspecified eyelid” takes H01.83; specificity in the record moves it back here.

    Full comparison: H01.8A vs H01.83 →

  • H01.8B— Laterality relationship (Review)

    Same condition; these differ only in which side is documented.

    The same condition with a different side named (the opposite side, both sides, or none); the documented side decides, and a bilateral code, where one exists, replaces the pair when both sides are documented.

    What moves you there: A documented left side moves the case to H01.8B.

    Full comparison: H01.8A vs H01.8B →

  • S01.1— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of open wound of eyelid adds S01.1; it is not part of this code and both may be reported when both are documented.

    Full comparison: H01.8A vs S01.1 →

  • S00.1— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of superficial injury of eyelid adds S00.1; it is not part of this code and both may be reported when both are documented.

    Full comparison: H01.8A vs S00.1 →

  • S00.2— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of superficial injury of eyelid adds S00.2; it is not part of this code and both may be reported when both are documented.

    Full comparison: H01.8A vs S00.2 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Other specified inflammation of right eye, upper and lower eyelids is a billable ICD-10-CM diagnosis code (H01.8A).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. Laterality is coded in this family. Confirm the documented side matches the code — the opposite-side siblings are in the relationships section. See the opposite-side sibling codes
  2. 1 Code Also note — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  3. 2 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name H01.8A or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Use Additional Code instruction: L51 — Erythema multiforme (via H01.8.-).

These codes instruct coders to additionally report this code when it applies.

Referenced by 1 Code Also instruction: B88.01 — Infestation by Demodex mites (via H01.8.-).

These codes suggest coding this condition alongside when both are present.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 2 MS-DRGs: DRG 124 (MDC 02), DRG 125 (MDC 02).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):EYE001 — Cornea and external disease (default); EYE008 — Oculofacial plastics and orbital conditions.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same condition, different side

Same title, differing only in which side of the body it names: right, left, bilateral or unspecified.

H01.8B — Other specified inflammation of left eye, upper and lower eyelidsCompare H01.8A vs H01.8B →

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Cornea and external disease, Oculofacial plastics and orbital conditions).

+1142 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Fistula”, “Granuloma”, “Inflammation, inflamed, inflammatory”, …; these codes share that main term but sit in a different category of the Tabular List.

E27.8 — Other specified disorders of adrenal gland (adrenal), E32.8 — Other diseases of thymus (thymus), E52 — Niacin deficiency [pellagra] (pellagrous), E54 — Ascorbic acid deficiency (scorbutic, alveoli, teeth), F54 — Psychological and behavioral factors associated with disorders or diseases classified elsewhere (psychogenic), G06.0 — Intracranial abscess and granuloma (brain), G06.1 — Intraspinal abscess and granuloma (intraspinal), G08 — Intracranial and intraspinal phlebitis and thrombophlebitis (vein, intracranial or intraspinal), G93.89 — Other specified disorders of brain (brain), G96.08 — Other cranial cerebrospinal fluid leak (cerebrospinal), H04.61 — Lacrimal fistula (lacrimal), H04.81 — Granuloma of lacrimal passages (lacrimal), H05.00 — Unspecified acute inflammation of orbit (orbit, acute), H05.10 — Unspecified chronic inflammatory disorders of orbit (orbit), H05.11 — Granuloma of orbit (orbit, orbital), H11.22 — Conjunctival granuloma (conjunctiva), H30.00 — Unspecified focal chorioretinal inflammation (chorioretinal, focal), H30.01 — Focal chorioretinal inflammation, juxtapapillary (chorioretinal, focal, juxtapapillary), H30.02 — Focal chorioretinal inflammation of posterior pole (chorioretinal, focal, posterior pole), H30.03 — Focal chorioretinal inflammation, peripheral (chorioretinal, focal, peripheral), +350 more

Contextual Map

Every relationship of H01.8A in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run H01.8A with these 2 related codes in Claim Check

Hierarchy

Referenced by Use Additional Code instructions

  • L51 — Erythema multiforme[Use Additional Code](via H01.8.-): “inflammation of eyelid (H01.8-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Referenced by Code Also instructions

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 02 — Diseases and Disorders of the Eye[MDC crossing]: “Diseases and Disorders of the Eye — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1,200 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Nearest codes (40)

Change history

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "H01.8A — Other specified inflammation of right eye, upper and lower eyelids." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/h01.8a-other-specified-inflammation-of-right-eye-upper-and-lower-eyelids

Change history

  • FY2026 — October 1, 2025
    Added to the code set
    Other specified inflammation of right eye, upper and lower eyelids
    FY2026 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to H01.8A in its code family, with their registry titles.

View all codes in the H01 family