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

ICD-10 H28

Billable / Specific

Cataract in diseases classified elsewhere

H28
Block
0
Synonyms
74
LCDs
9
Payer Policies
0
Linked CPTs

About ICD-10-CM H28

ICD-10-CM code H28 represents Cataract in diseases classified elsewhere. This is a billable/specific code in the Eye and Adnexa chapter (block H28). The 2026 edition of ICD-10-CM H28 became effective on October 1, 2025.

Type 1 Excludes

Pure excludes, these codes can never be coded together with H28. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • cataract in diabetes mellitus (E08.36, E09.36, E10.36, E11.36, E13.36)

Coding Notes

Code First

  • underlying disease, such as:
  • hypoparathyroidism (E20.-)
  • myotonia (G71.1-)
  • myxedema (E03.-)
  • protein-calorie malnutrition (E40-E46)

Medicare LCD Coverage for H28

Local Coverage Determinations (LCDs) from CMS MACs that list H28 as a covered diagnosis.

74 LCDs

Showing top 10 of 74 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Ophthalmic Biometry for Intraocular Lens Power Calculation
Article ID: 56549, Effective: 2019-09-19 00:00:00, 97 covered, 0 non-covered
CPT 92136 →
CMS LCD: Billing and Coding: Ophthalmic Biometry for Intraocular Lens Power Calculation
Article ID: 56549, Effective: 2019-09-19 00:00:00, 97 covered, 0 non-covered
CPT 76519 →
CMS LCD: Billing and Coding: Cataract Surgery
Article ID: 56613, Effective: 2025-10-01 00:00:00, 163 covered, 0 non-covered
CPT 66982 →
CMS LCD: Billing and Coding: Cataract Surgery
Article ID: 56613, Effective: 2025-10-01 00:00:00, 163 covered, 0 non-covered
CPT 66983 →
CMS LCD: Billing and Coding: Cataract Surgery
Article ID: 56613, Effective: 2025-10-01 00:00:00, 163 covered, 0 non-covered
CPT 66852 →
CMS LCD: Billing and Coding: Cataract Surgery
Article ID: 56613, Effective: 2025-10-01 00:00:00, 163 covered, 0 non-covered
CPT 66850 →
CMS LCD: Billing and Coding: Cataract Surgery
Article ID: 56613, Effective: 2025-10-01 00:00:00, 163 covered, 0 non-covered
CPT 66989 →
CMS LCD: Billing and Coding: Cataract Surgery
Article ID: 56613, Effective: 2025-10-01 00:00:00, 163 covered, 0 non-covered
CPT 66840 →
CMS LCD: Billing and Coding: Cataract Surgery
Article ID: 56613, Effective: 2025-10-01 00:00:00, 163 covered, 0 non-covered
CPT 66991 →
CMS LCD: Billing and Coding: Cataract Surgery
Article ID: 56613, Effective: 2025-10-01 00:00:00, 163 covered, 0 non-covered
CPT 66940 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing H28.

9 policies

5 Medicare

Billing and Coding: Cataract Extraction
Policy ID: ART-56453
Billing and Coding: Ophthalmic Biometry for Intraocular Lens Power Calculation
Policy ID: ART-56549
Billing and Coding: Cataract Surgery
Policy ID: ART-56613
Billing and Coding: Cataract Extraction (including Complex Cataract Surgery)
Policy ID: ART-56615
Billing and Coding: Ophthalmic Biometry for Intraocular Lens Power Calculation
Policy ID: ART-57070

CPT Codes Commonly Billed with H28

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

No procedure linkages on file for H28

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.

Convert H28 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
H28 36644 10000

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

ICD-10 H28, Billing FAQ

Is ICD-10 code H28 billable? +

Yes, H28 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 1 Excludes for H28? +

Type 1 Excludes (never code together with H28): cataract in diabetes mellitus (E08.36, E09.36, E10.36, E11.36, E13.36)

What ICD-9 codes does H28 map to? +

Per CMS GEMs, H28 maps to ICD-9 codes: 36644. 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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