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

ICD-10 H21.81

Billable / Specific

Floppy iris syndrome

H21
Block
1
Synonyms
87
LCDs
12
Payer Policies
9
Linked CPTs

About ICD-10-CM H21.81

ICD-10-CM code H21.81 represents Floppy iris syndrome. This is a billable/specific code in the Eye and Adnexa chapter (block H21). The 2026 edition of ICD-10-CM H21.81 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under H21.81. Per CMS ICD-10-CM Tabular 2026.

  • Intraoperative floppy iris syndrome (IFIS)

Use Additional Code

When coding H21.81, also report these additional codes when applicable.

  • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Medicare LCD Coverage for H21.81

Local Coverage Determinations (LCDs) from CMS MACs that list H21.81 as a covered diagnosis.

87 LCDs

Showing top 10 of 87 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92201 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92250 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92202 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92227 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92228 →
CMS LCD: Billing and Coding: Cataract Extraction
Article ID: 56453, Effective: 2025-10-01 00:00:00, 422 covered, 0 non-covered
CPT 66982 →
CMS LCD: Billing and Coding: Cataract Extraction
Article ID: 56453, Effective: 2025-10-01 00:00:00, 422 covered, 0 non-covered
CPT 66983 →
CMS LCD: Billing and Coding: Cataract Extraction
Article ID: 56453, Effective: 2025-10-01 00:00:00, 422 covered, 0 non-covered
CPT 66852 →
CMS LCD: Billing and Coding: Cataract Extraction
Article ID: 56453, Effective: 2025-10-01 00:00:00, 422 covered, 0 non-covered
CPT 66850 →
CMS LCD: Billing and Coding: Cataract Extraction
Article ID: 56453, Effective: 2025-10-01 00:00:00, 422 covered, 0 non-covered
CPT 66840 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing H21.81.

12 policies

5 Medicare

Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Policy ID: ART-53060
Billing and Coding: Cataract Extraction
Policy ID: ART-56453
Billing and Coding: Cataract Extraction
Policy ID: ART-56544
Billing and Coding: Cataract Extraction (including Complex Cataract Surgery)
Policy ID: ART-56615
Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
Policy ID: ART-56726

CPT Codes Commonly Billed with H21.81

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

9 linkages
  • 66987 CMS LCD: Billing and Coding: Cataract Extraction (including Complex Cataract Surgery) CMS LCD
  • 66840 CMS LCD: Billing and Coding: Cataract Extraction (including Complex Cataract Surgery) CMS LCD
  • 66852 CMS LCD: Billing and Coding: Cataract Extraction (including Complex Cataract Surgery) CMS LCD
  • 66850 CMS LCD: Billing and Coding: Cataract Extraction (including Complex Cataract Surgery) CMS LCD
  • 66940 CMS LCD: Billing and Coding: Cataract Extraction (including Complex Cataract Surgery) CMS LCD
  • 66983 CMS LCD: Billing and Coding: Cataract Extraction (including Complex Cataract Surgery) CMS LCD
  • 66988 CMS LCD: Billing and Coding: Cataract Extraction (including Complex Cataract Surgery) CMS LCD
  • 66982 CMS LCD: Billing and Coding: Cataract Extraction (including Complex Cataract Surgery) CMS LCD
  • 66920 CMS LCD: Billing and Coding: Cataract Extraction (including Complex Cataract Surgery) CMS LCD

Convert H21.81 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
H21.81 36481 00000

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

ICD-10 H21.81, Billing FAQ

Is ICD-10 code H21.81 billable? +

Yes, H21.81 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to H21.81? +

ICD-10 H21.81 includes: Intraoperative floppy iris syndrome (IFIS).

What CPT codes are commonly billed with H21.81? +

Procedures frequently paired with H21.81 include: 66987, 66840, 66852, 66850, 66940.

What ICD-9 codes does H21.81 map to? +

Per CMS GEMs, H21.81 maps to ICD-9 codes: 36481. 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 June 1, 2026.

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