ICD-10 H05.5
Non-Billable HeaderRetained (old) foreign body following penetrating wound of orbit
About ICD-10-CM H05.5
ICD-10-CM code H05.5 represents Retained (old) foreign body following penetrating wound of orbit. This is a non-billable header code in the Eye and Adnexa chapter (block H05). The 2026 edition of ICD-10-CM H05.5 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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under H05.5. Per CMS ICD-10-CM Tabular 2026.
- Retrobulbar foreign body
Type 1 Excludes
Pure excludes, these codes can never be coded together with H05.5. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- current penetrating wound of orbit (S05.4-)
Type 2 Excludes
Not included here, the excluded code is not part of H05.5, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- retained foreign body of eyelid (H02.81-)
- retained intraocular foreign body (H44.6-, H44.7-)
Use Additional Code
When coding H05.5, also report these additional codes when applicable.
- code to identify the type of retained foreign body (Z18.-)
Medicare LCD Coverage for H05.5
Local Coverage Determinations (LCDs) from CMS MACs that list H05.5 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 H05.5.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but H05.5 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with H05.5
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 H05.5
Other codes in section H00-H05 (Disorders of eyelid, lacrimal system and orbit).
ICD-10 H05.5, Billing FAQ
Is ICD-10 code H05.5 billable? +
No, H05.5 is a non-billable header code. Use a more specific child code from block H05 when submitting claims.
What other names or terms map to H05.5? +
ICD-10 H05.5 includes: Retrobulbar foreign body.
What codes are Type 1 Excludes for H05.5? +
Type 1 Excludes (never code together with H05.5): current penetrating wound of orbit (S05.4-)
What codes are Type 2 Excludes for H05.5? +
Type 2 Excludes (may be coded together when both conditions exist): retained foreign body of eyelid (H02.81-); retained intraocular foreign body (H44.6-, H44.7-)
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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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