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

ICD-10 H26

Non-Billable Header

Other cataract

H26
Block
0
Synonyms
0
LCDs
0
Payer Policies
0
Linked CPTs

About ICD-10-CM H26

ICD-10-CM code H26 represents Other cataract. This is a non-billable header code in the Eye and Adnexa chapter (block H26). The 2026 edition of ICD-10-CM H26 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 H26. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • congenital cataract (Q12.0)

Medicare LCD Coverage for H26

Local Coverage Determinations (LCDs) from CMS MACs that list H26 as a covered diagnosis.

No Medicare LCDs reference H26 as covered

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 H26.

No commercial payer policies reference H26 on file

Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but H26 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.

CPT Codes Commonly Billed with H26

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

No procedure linkages on file for H26

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.

ICD-10 H26, Billing FAQ

Is ICD-10 code H26 billable? +

No, H26 is a non-billable header code. Use a more specific child code from block H26 when submitting claims.

What codes are Type 1 Excludes for H26? +

Type 1 Excludes (never code together with H26): congenital cataract (Q12.0)

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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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