ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 B02.31

Billable / Specific CC

Zoster conjunctivitis

B02
Block
0
Synonyms
566
LCDs
6
Payer Policies
1
Linked CPTs

About ICD-10-CM B02.31

ICD-10-CM code B02.31 represents Zoster conjunctivitis. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block B02). The 2026 edition of ICD-10-CM B02.31 became effective on October 1, 2025.

Coding Tips for B02.31

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

B02.31 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inpatient DRG Impact, CC

codes Zoster conjunctivitis. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for B02.31

Local Coverage Determinations (LCDs) from CMS MACs that list B02.31 as a covered diagnosis.

566 LCDs

Showing top 10 of 566 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87555 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87653 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87486 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87626 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 0109U →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87516 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87517 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87528 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87476 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87594 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing B02.31.

6 policies

5 Medicare

Billing and Coding: Ocular Photography - External
Policy ID: ART-57068
Billing and Coding: MRI and CT Scans of the Head and Neck
Policy ID: ART-57204
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Policy ID: ART-58710
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Policy ID: ART-58720
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Policy ID: ART-58747

CPT Codes Commonly Billed with B02.31

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

1 linkages
  • 92285 CMS LCD: Billing and Coding: Ocular Photography - External CMS LCD

Convert B02.31 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
B02.31 05329 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 B02.31, Billing FAQ

Is ICD-10 code B02.31 billable? +

Yes, B02.31 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is B02.31 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What CPT codes are commonly billed with B02.31? +

Procedures frequently paired with B02.31 include: 92285.

What ICD-9 codes does B02.31 map to? +

Per CMS GEMs, B02.31 maps to ICD-9 codes: 05329. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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