ICD-10 H05
Non-Billable HeaderDisorders of orbit
About ICD-10-CM H05
ICD-10-CM code H05 represents Disorders of orbit. This is a non-billable header code in the Eye and Adnexa chapter (block H05). The 2026 edition of ICD-10-CM H05 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with H05. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- congenital malformation of orbit (Q10.7)
Medicare LCD Coverage for H05
Local Coverage Determinations (LCDs) from CMS MACs that list H05 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing H05.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but H05 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with H05
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To H05
Other codes in section H00-H05 (Disorders of eyelid, lacrimal system and orbit).
ICD-10 H05, Billing FAQ
Is ICD-10 code H05 billable? +
No, H05 is a non-billable header code. Use a more specific child code from block H05 when submitting claims.
What codes are Type 1 Excludes for H05? +
Type 1 Excludes (never code together with H05): congenital malformation of orbit (Q10.7)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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