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H05.019 ICD-10-CM Code: Cellulitis of unspecified orbit

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

Coding at a Glance

Tabular directives
1 Excludes1 · 2 Excludes2

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 121 — ACUTE MAJOR EYE INFECTIONS WITH CC/MCC (MDC 02)
  • MS-DRG 122 — ACUTE MAJOR EYE INFECTIONS WITHOUT CC/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 H05.019 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 H05.019 itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from H05

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

Coder workflow for H05.019

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

Before you code H05.019

  1. Unspecified does not mean incorrect. When the record gives no greater specificity, H05.019 may be the appropriate code. Check the record for detail that supports a more specific sibling. An unspecified code is for records that do not provide the detail a more specific code needs; a query, not an assumption, is the route to specificity (Guidelines I.A.9.b, I.B.18).

    ReviewH05.011, H05.012, H05.013

    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: unspecified). 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).

    ReviewH05.011 · right, H05.012 · left

    Guide: Laterality coding →

  3. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with H05.019. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the record document the detail a more specific sibling code needs?
    Yes → Review the specific siblings in this subcategory.
    No → Continue — H05.019 is appropriate when the documentation goes no further.

    ReviewH05.011, H05.012, H05.013

  2. Does the documentation support a condition named in H05.019’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewQ10.7

  3. 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.

    ReviewH05.011 · right, H05.012 · left

Consider H05.019. Then 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 sibling code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

  • Excludes1 — check before selecting H05.019(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with H05.019: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareQ10.7

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

  • Excludes2 — not part of H05.019(2 notes)

    Coding workflow: The conditions named in this note are not included in H05.019. 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

Coding decision scenarios

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

Documentation: The provider documents the condition in the terms of this code’s title and records no further detail.

Coding question: Is a more specific sibling code supportable?

Path: Review the specific siblings in this subcategory and what each requires the record to state.

Reason: A more specific code needs documentation of the distinguishing element; without it the unspecified code is appropriate, and a provider query is the route to specificity (Guidelines I.A.9.b, I.B.18).

ReviewH05.011, H05.012, H05.013

Documentation: Both the condition H05.019 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewQ10.7

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).

ReviewH05.011 · right, H05.012 · 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 H05.019 with…

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

The codes most likely to be picked instead of H05.019 — 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.

  • Q10.7— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of congenital malformation of orbit moves the case to Q10.7; the two are not reported together unless documented as unrelated.

    Full comparison: H05.019 vs Q10.7 →

  • H05.011— Laterality relationship (Review)

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

    The same condition on the other side; 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 right side moves the case to H05.011.

    Full comparison: H05.019 vs H05.011 →

  • H05.012— Laterality relationship (Review)

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

    The same condition on the other side; 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 H05.012.

    Full comparison: H05.019 vs H05.012 →

  • 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: H05.019 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: H05.019 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: H05.019 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.

Code Overview

Cellulitis of unspecified orbit is a billable ICD-10-CM diagnosis code (H05.019).

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

Verify Before Coding

  • CC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.

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 structured relationships — computed from published CMS and AHRQ datasets

Other codes that name H05.019 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 2 Excludes2 notes across 2 chapters: L03.211 — Cellulitis of face (via H05.01.-), M86 — Osteomyelitis (via H05.0.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 17 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 2 MS-DRGs: DRG 121 (MDC 02), DRG 122 (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):EYE008 — Oculofacial plastics and orbital conditions (default); SKN001 — Skin and subcutaneous tissue infections.

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 clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

H05.00 — Unspecified acute inflammation of orbit, H05.011 — Cellulitis of right orbit, H05.012 — Cellulitis of left orbit, H05.013 — Cellulitis of bilateral orbits, H05.021 — Osteomyelitis of right orbit, H05.022 — Osteomyelitis of left orbit, H05.023 — Osteomyelitis of bilateral orbits, H05.029 — Osteomyelitis of unspecified orbit, H05.031 — Periostitis of right orbit, H05.032 — Periostitis of left orbit, H05.033 — Periostitis of bilateral orbits, H05.039 — Periostitis of unspecified orbit, H05.041 — Tenonitis of right orbit, H05.042 — Tenonitis of left orbit, H05.043 — Tenonitis of bilateral orbits, H05.049 — Tenonitis of unspecified orbit

Same condition, opposite side

Same category and title, differing only in which side of the body is affected.

H05.011 — Cellulitis of right orbit (right)Compare H05.019 vs H05.011 →, H05.012 — Cellulitis of left orbit (left)Compare H05.019 vs H05.012 →

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Oculofacial plastics and orbital conditions, Skin and subcutaneous tissue infections).

A21.0 — Ulceroglandular tularemia, A22.0 — Cutaneous anthrax, A31.1 — Cutaneous mycobacterial infection, A36.3 — Cutaneous diphtheria, A43.1 — Cutaneous nocardiosis, A46 — Erysipelas, A51.39 — Other secondary syphilis of skin, H05.011 — Cellulitis of right orbit, H05.012 — Cellulitis of left orbit, H05.013 — Cellulitis of bilateral orbits, L00 — Staphylococcal scalded skin syndrome, L01.00 — Impetigo, unspecified, L01.01 — Non-bullous impetigo, L01.02 — Bockhart's impetigo, L01.03 — Bullous impetigo, L01.09 — Other impetigo, L01.1 — Impetiginization of other dermatoses, L02.01 — Cutaneous abscess of face, L02.02 — Furuncle of face, L02.03 — Carbuncle of face, +674 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Cellulitis”; these codes share that main term but sit in a different category of the Tabular List.

A18.4 — Tuberculosis of skin and subcutaneous tissue (tuberculous), A48.0 — Gas gangrene (anaerobic), A54.89 — Other gonococcal infections (gonococcal), H60.1 — Cellulitis of external ear (ear), J34.0 — Abscess, furuncle and carbuncle of nose (nose), J36 — Peritonsillar abscess (tonsil), J38.3 — Other diseases of vocal cords (vocal cord), J38.7 — Other diseases of larynx (larynx), J39.1 — Other abscess of pharynx (pharynx), K11.3 — Abscess of salivary gland (submaxillary, gland), K12.2 — Cellulitis and abscess of mouth (mouth), K13.0 — Diseases of lips (lip), K61.0 — Anal abscess (anus), K61.1 — Rectal abscess (rectum), K65.0 — Generalized (acute) peritonitis (pelvis, pelvic, male), K68.9 — Other disorders of retroperitoneum (retroperitoneal), L03.01 — Cellulitis of finger (finger), L03.03 — Cellulitis of toe (toe), L03.11 — Cellulitis of other parts of limb (axilla), L03.211 — Cellulitis of face (jaw), +30 more

Contextual Map

Every relationship of H05.019 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 H05.019 with these 2 related codes in Claim Check

Hierarchy

Referenced by Excludes2 notes

  • L03.211 — Cellulitis of face[Excludes2](via H05.01.-): “abscess of orbit (H05.01-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • M86 — Osteomyelitis[Excludes2](via H05.0.-): “orbit (H05.0-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

MS-DRG Grouper

  • CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2027
  • DRG 121 — ACUTE MAJOR EYE INFECTIONS WITH CC/MCC[MS-DRG]: “ACUTE MAJOR EYE INFECTIONS WITH CC/MCC (MDC 02)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
  • DRG 122 — ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC[MS-DRG]: “ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC (MDC 02)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027

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

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

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 structured 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 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.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

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. "H05.019 — Cellulitis of unspecified orbit." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/h05.019-cellulitis-of-unspecified-orbit

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Cellulitis of unspecified orbit

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to H05.019 in its code family, with their registry titles.

View all codes in the H05 family