Non-Billable / Non-Specific Code
ICD-10-CM H04.5 is the diagnosis code for Stenosis and insufficiency of lacrimal passages. This code falls under the section "Disorders of eyelid, lacrimal system and orbit" within Chapter 7 — Diseases of the eye and adnexa (H00-H59). It is a non-billable/non-specific ICD-10-CM code that should not be used for reimbursement. A more specific sub-code is required for billing. Medical coders and healthcare providers use this code to document and classify diagnoses in electronic health records, insurance claims, and clinical databases.
Always refer to the official ICD-10-CM Tabular List for complete coding guidelines. Ensure documentation supports the specificity of the code selected. When in doubt, consult a certified medical coder or the latest CMS guidelines.
Understanding where H04.5 sits in the ICD-10-CM classification helps ensure proper coding:
No, H04.5 is a non-billable/non-specific code. You should use a more specific sub-code for billing and reimbursement.
H04.5 is the ICD-10-CM diagnosis code for "Stenosis and insufficiency of lacrimal passages". It is used by healthcare providers to classify and document this condition in medical records and insurance claims.
The parent code of H04.5 is H04 ("Disorders of lacrimal system"). H04.5 provides a more specific classification within this category.
H04.5 is located in Section H00-H05 — "Disorders of eyelid, lacrimal system and orbit" within Chapter 7 of the ICD-10-CM Tabular List.
H04.5 has 7 sub-code(s) that provide more specific detail: H04.51, H04.52, H04.53, H04.54, H04.55 and more.
Use H04.5 when the patients documented diagnosis matches "Stenosis and insufficiency of lacrimal passages" and the clinical documentation supports this level of specificity. Always verify with the latest ICD-10-CM guidelines and payer requirements.
The ICD-10-CM code for Stenosis and insufficiency of lacrimal passages is H04.5.
No, H04.5 is non-billable. Use a more specific sub-code for primary diagnosis billing.
H04.5 is in Chapter 7 of the ICD-10-CM Tabular List.
Yes, H04.5 is a valid ICD-10-CM code for the 2026 fiscal year, subject to official CMS updates.