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H04.009

Billable

Unspecified dacryoadenitis, unspecified lacrimal gland

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

This code describes inflammation of the lacrimal gland (the gland that produces tears) when the specific location and cause are not documented. The lacrimal gland is located above the eye and helps keep the eye moist.

Coding Tips

  • Query the provider if more specific information is available, such as which eye is affected (right vs. left) or the underlying cause, as this would allow for a more specific code (H04.00 codes specify laterality)
  • Ensure documentation clearly indicates dacryoadenitis (inflammation of the lacrimal gland) rather than other lacrimal gland conditions like dacryocystitis (inflammation of the tear sac) to avoid miscoding

Code Hierarchy

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