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

ICD-10 H20.059

Billable / Specific

Hypopyon, unspecified eye

H20
Block
0
Synonyms
7
LCDs
4
Payer Policies
4
Linked CPTs

About ICD-10-CM H20.059

ICD-10-CM code H20.059 represents Hypopyon, unspecified eye. This is a billable/specific code in the Eye and Adnexa chapter (block H20). The 2026 edition of ICD-10-CM H20.059 became effective on October 1, 2025.

Medicare LCD Coverage for H20.059

Local Coverage Determinations (LCDs) from CMS MACs that list H20.059 as a covered diagnosis.

7 LCDs

Showing top 7. Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Infliximab and biosimilars
Article ID: 52423, Effective: 2024-10-01 00:00:00, 619 covered, 0 non-covered
CPT J1745 →
CMS LCD: Billing and Coding: Infliximab and biosimilars
Article ID: 52423, Effective: 2024-10-01 00:00:00, 619 covered, 0 non-covered
CPT Q5103 →
CMS LCD: Billing and Coding: Infliximab and biosimilars
Article ID: 52423, Effective: 2024-10-01 00:00:00, 619 covered, 0 non-covered
CPT Q5121 →
CMS LCD: Billing and Coding: Infliximab and biosimilars
Article ID: 52423, Effective: 2024-10-01 00:00:00, 619 covered, 0 non-covered
CPT Q5104 →
CMS LCD: Billing and Coding: Visual Field Examination
Article ID: 57637, Effective: 2025-10-01 00:00:00, 2832 covered, 1 non-covered
CPT 92082 →
CMS LCD: Billing and Coding: Visual Field Examination
Article ID: 57637, Effective: 2025-10-01 00:00:00, 2832 covered, 1 non-covered
CPT 92083 →
CMS LCD: Billing and Coding: Visual Field Examination
Article ID: 57637, Effective: 2025-10-01 00:00:00, 2832 covered, 1 non-covered
CPT 92081 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing H20.059.

4 policies

2 Medicare

Billing and Coding: Infliximab and biosimilars
Policy ID: ART-52423
Billing and Coding: Visual Field Examination
Policy ID: ART-57637

2 Aetna

Cataract Surgery
Policy ID: CPB-0508
External Ocular Photography
Policy ID: CPB-0734

CPT Codes Commonly Billed with H20.059

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

4 linkages
  • J1745 CMS LCD: Billing and Coding: Infliximab and biosimilars CMS LCD
  • Q5104 CMS LCD: Billing and Coding: Infliximab and biosimilars CMS LCD
  • Q5121 CMS LCD: Billing and Coding: Infliximab and biosimilars CMS LCD
  • Q5103 CMS LCD: Billing and Coding: Infliximab and biosimilars CMS LCD

Convert H20.059 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
H20.059 36405 10000

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

ICD-10 H20.059, Billing FAQ

Is ICD-10 code H20.059 billable? +

Yes, H20.059 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with H20.059? +

Procedures frequently paired with H20.059 include: J1745, Q5104, Q5121, Q5103.

What ICD-9 codes does H20.059 map to? +

Per CMS GEMs, H20.059 maps to ICD-9 codes: 36405. 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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