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

ICD-10 H59.42

Billable / Specific

Inflammation (infection) of postprocedural bleb, stage 2

H59
Block
0
Synonyms
45
LCDs
6
Payer Policies
0
Linked CPTs

About ICD-10-CM H59.42

ICD-10-CM code H59.42 represents Inflammation (infection) of postprocedural bleb, stage 2. This is a billable/specific code in the Eye and Adnexa chapter (block H59). The 2026 edition of ICD-10-CM H59.42 became effective on October 1, 2025.

Medicare LCD Coverage for H59.42

Local Coverage Determinations (LCDs) from CMS MACs that list H59.42 as a covered diagnosis.

45 LCDs

Showing top 10 of 45 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: Visual Fields Testing
Article ID: 56551, Effective: 2025-10-01 00:00:00, 1427 covered, 0 non-covered
CPT 92082 →
CMS LCD: Billing and Coding: Visual Fields Testing
Article ID: 56551, Effective: 2025-10-01 00:00:00, 1427 covered, 0 non-covered
CPT 92083 →
CMS LCD: Billing and Coding: Visual Fields Testing
Article ID: 56551, Effective: 2025-10-01 00:00:00, 1427 covered, 0 non-covered
CPT 92081 →
CMS LCD: Billing and Coding: Magnetic Resonance Imaging of the Head and Neck
Article ID: 56729, Effective: 2025-10-01 00:00:00, 1057 covered, 0 non-covered
CPT 70543 →
CMS LCD: Billing and Coding: Magnetic Resonance Imaging of the Head and Neck
Article ID: 56729, Effective: 2025-10-01 00:00:00, 1057 covered, 0 non-covered
CPT 70542 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing H59.42.

6 policies

5 Medicare

Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Policy ID: ART-53060
Billing and Coding: Visual Fields Testing
Policy ID: ART-56551
Billing and Coding: Magnetic Resonance Imaging of the Head and Neck
Policy ID: ART-56729
Billing and Coding: Visual Fields Testing
Policy ID: ART-56799
Billing and Coding: MRI and CT Scans of the Head and Neck
Policy ID: ART-57204

CPT Codes Commonly Billed with H59.42

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

No procedure linkages on file for H59.42

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 H59.42 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
H59.42 37962 00000

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

Codes Adjacent To H59.42

Other codes in section H59 (Intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified).

H59 Intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified (non-billable) H59.0 Disorders of the eye following cataract surgery (non-billable) H59.01 Keratopathy (bullous aphakic) following cataract surgery (non-billable) H59.011 Keratopathy (bullous aphakic) following cataract surgery, right eye H59.012 Keratopathy (bullous aphakic) following cataract surgery, left eye H59.013 Keratopathy (bullous aphakic) following cataract surgery, bilateral H59.019 Keratopathy (bullous aphakic) following cataract surgery, unspecified eye H59.02 Cataract (lens) fragments in eye following cataract surgery (non-billable) H59.021 Cataract (lens) fragments in eye following cataract surgery, right eye H59.022 Cataract (lens) fragments in eye following cataract surgery, left eye H59.023 Cataract (lens) fragments in eye following cataract surgery, bilateral H59.029 Cataract (lens) fragments in eye following cataract surgery, unspecified eye H59.03 Cystoid macular edema following cataract surgery (non-billable) H59.031 Cystoid macular edema following cataract surgery, right eye H59.032 Cystoid macular edema following cataract surgery, left eye H59.033 Cystoid macular edema following cataract surgery, bilateral H59.039 Cystoid macular edema following cataract surgery, unspecified eye H59.09 Other disorders of the eye following cataract surgery (non-billable) H59.091 Other disorders of the right eye following cataract surgery H59.092 Other disorders of the left eye following cataract surgery

ICD-10 H59.42, Billing FAQ

Is ICD-10 code H59.42 billable? +

Yes, H59.42 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What ICD-9 codes does H59.42 map to? +

Per CMS GEMs, H59.42 maps to ICD-9 codes: 37962. 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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