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H40.43X1 ICD-10-CM Code: Glaucoma secondary to eye inflammation, bilateral, mild stage

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

Glaucoma secondary to eye inflammation, bilateral, mild stage is a billable ICD-10-CM diagnosis code (H40.431).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for H40.43X1 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).

Code Also

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

  • underlying condition

Frequently Compared Codes

The official Excludes notes on H40.43X1 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

Official ICD-10-CM tabular notes on other codes that name H40.43X1 or its code family.

1 Excludes2 notes: H20.8 (via H40.4.-).

1 Code First instructions: H26.23 (via H40.-).

5 Use Additional Code instructions: E08.39 (via H40.-), E09.39 (via H40.-), E10.39 (via H40.-), E11.39 (via H40.-), E13.39 (via H40.-).

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):EYE003 — Glaucoma (default).

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

Contextual Map

Every relationship of H40.43X1 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]
  • H40-H42 — Glaucoma [Hierarchy]

Referenced by Excludes2 notes

  • H20.8 — Other iridocyclitis [Excludes2](via H40.4.-): “glaucomatocyclitis crises (H40.4-)” · check together

Referenced by Code First instructions

  • H26.23 — Glaucomatous flecks (subcapsular) [Code First](via H40.-): “underlying glaucoma (H40-H42)” · check together

Referenced by Use Additional Code instructions

  • E08.39 — Diabetes mellitus due to underlying condition with other diabetic ophthalmic complication [Use Additional Code](via H40.-): “diabetic glaucoma (H40-H42)” · check together
  • E09.39 — Drug or chemical induced diabetes mellitus with other diabetic ophthalmic complication [Use Additional Code](via H40.-): “diabetic glaucoma (H40-H42)” · check together
  • E10.39 — Type 1 diabetes mellitus with other diabetic ophthalmic complication [Use Additional Code](via H40.-): “diabetic glaucoma (H40-H42)” · check together
  • E11.39 — Type 2 diabetes mellitus with other diabetic ophthalmic complication [Use Additional Code](via H40.-): “diabetic glaucoma (H40-H42)” · check together
  • E13.39 — Other specified diabetes mellitus with other diabetic ophthalmic complication [Use Additional Code](via H40.-): “diabetic glaucoma (H40-H42)” · check together

Clinical classification (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)

  • H40 — Glaucoma [Sibling]
  • H40.40 — Glaucoma secondary to eye inflammation, unspecified eye [Sibling]
  • H40.40X0 — Glaucoma secondary to eye inflammation, unspecified eye, stage unspecified [Sibling]
  • H40.40X1 — Glaucoma secondary to eye inflammation, unspecified eye, mild stage [Sibling]
  • H40.40X2 — Glaucoma secondary to eye inflammation, unspecified eye, moderate stage [Sibling]
  • H40.40X3 — Glaucoma secondary to eye inflammation, unspecified eye, severe stage [Sibling]
  • H40.40X4 — Glaucoma secondary to eye inflammation, unspecified eye, indeterminate stage [Sibling]
  • H40.41 — Glaucoma secondary to eye inflammation, right eye [Sibling]
  • and 32 more

Frequently Asked Questions (FAQ) & Clinical Guidance

Does H40.43X1 require a 7th character?

Yes. One of the following 7th characters is to be assigned to each code in subcategory H40.4 to designate the stage of glaucoma.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to H40.43X1 in its code family, with their registry titles.

  • H40.42X2 — Glaucoma secondary to eye inflammation, left eye, moderate stage
  • H40.42X3 — Glaucoma secondary to eye inflammation, left eye, severe stage
  • H40.42X4 — Glaucoma secondary to eye inflammation, left eye, indeterminate stage
  • H40.43 — Glaucoma secondary to eye inflammation, bilateral
  • H40.43X0 — Glaucoma secondary to eye inflammation, bilateral, stage unspecified
  • H40.43X2 — Glaucoma secondary to eye inflammation, bilateral, moderate stage
  • H40.43X3 — Glaucoma secondary to eye inflammation, bilateral, severe stage
  • H40.43X4 — Glaucoma secondary to eye inflammation, bilateral, indeterminate stage
  • H40.5 — Glaucoma secondary to other eye disorders
  • H40.50 — Glaucoma secondary to other eye disorders, unspecified eye

View all codes in the H40 family