Skip to main content

H16.223 ICD-10-CM Code: Keratoconjunctivitis sicca, not specified as Sjögren's, bilateral

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

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, 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.

Official Registry Overview & Definition

Keratoconjunctivitis sicca, not specified as Sjögren's, bilateral is a billable ICD-10-CM diagnosis code (H16.223).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for H16.223 in the official ICD-10-CM tabular list.

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).

Frequently Compared Codes

The official Excludes notes on H16.223 name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.

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.

Relationships & Classification

Other codes that name H16.223 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.

2 Excludes1 notes: H10 (via H16.2.-), H11 (via H16.2.-).

1 Excludes2 notes: H44.1 (via H16.2.-).

1 Use Additional Code instructions: L51 (via H16.22.-).

Potential MS-DRG Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

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).

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 category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Cornea and external disease).

+809 more

Contextual Map

Every relationship of H16.223 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.

Hierarchy

  • H00-H59 — Chapter 7: Diseases of the Eye and Adnexa (H00-H59) (H00-H59) [Hierarchy]
  • H15-H22 — Disorders of sclera, cornea, iris and ciliary body [Hierarchy]

Referenced by Excludes1 notes

  • H10 — Conjunctivitis [Excludes1](via H16.2.-): “keratoconjunctivitis (H16.2-)” · check together
  • H11 — Other disorders of conjunctiva [Excludes1](via H16.2.-): “keratoconjunctivitis (H16.2-)” · check together

Referenced by Excludes2 notes

  • H44.1 — Other endophthalmitis [Excludes2](via H16.2.-): “ophthalmia nodosa (H16.2-)” · check together

Referenced by Use Additional Code instructions

  • L51 — Erythema multiforme [Use Additional Code](via H16.22.-): “keratoconjunctivitis sicca (H16.22-)” · check together

Clinical classification (CCSR)

  • EYE001 — Cornea and external disease [CCSR]

Potential MS-DRG

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

MDC crossing · procedures (1200)

  • 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.”
  • 039S0ZX — Drainage of Right Temporal Artery, Open Approach, Diagnostic [Same-MDC procedure]: “Drainage of Right Temporal Artery, Open Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
  • 039S4ZX — Drainage of Right Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic [Same-MDC procedure]: “Drainage of Right Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
  • 039T0ZX — Drainage of Left Temporal Artery, Open Approach, Diagnostic [Same-MDC procedure]: “Drainage of Left Temporal Artery, Open Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
  • 039T4ZX — Drainage of Left Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic [Same-MDC procedure]: “Drainage of Left Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
  • 03BS0ZX — Excision of Right Temporal Artery, Open Approach, Diagnostic [Same-MDC procedure]: “Excision of Right Temporal Artery, Open Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
  • and 1195 more

Nearest codes (40)

  • H16 — Keratitis [Sibling]
  • H16.139 — Photokeratitis, unspecified eye [Sibling]
  • H16.14 — Punctate keratitis [Sibling]
  • H16.141 — Punctate keratitis, right eye [Sibling]
  • H16.142 — Punctate keratitis, left eye [Sibling]
  • H16.143 — Punctate keratitis, bilateral [Sibling]
  • H16.149 — Punctate keratitis, unspecified eye [Sibling]
  • H16.2 — Keratoconjunctivitis [Sibling]
  • and 32 more

Nearest Codes in This Family

Official ICD-10-CM classifications closest to H16.223 in its code family, with their registry titles.

  • H16.213 — Exposure keratoconjunctivitis, bilateral
  • H16.219 — Exposure keratoconjunctivitis, unspecified eye
  • H16.22 — Keratoconjunctivitis sicca, not specified as Sjögren's
  • H16.221 — Keratoconjunctivitis sicca, not specified as Sjögren's, right eye
  • H16.222 — Keratoconjunctivitis sicca, not specified as Sjögren's, left eye
  • H16.229 — Keratoconjunctivitis sicca, not specified as Sjögren's, unspecified eye
  • H16.23 — Neurotrophic keratoconjunctivitis
  • H16.231 — Neurotrophic keratoconjunctivitis, right eye
  • H16.232 — Neurotrophic keratoconjunctivitis, left eye
  • H16.233 — Neurotrophic keratoconjunctivitis, bilateral

View all codes in the H16 family