H04.143 ICD-10-CM Code: Primary lacrimal gland atrophy, bilateral lacrimal glands
H04.143 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of eyelid, lacrimal system and orbit (H00-H05)
H04.143
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePrimary lacrimal gland atrophy, bilateral lacrimal glands
This condition involves the shrinking or wasting away of both tear-producing glands (lacrimal glands) located near the eyes. This leads to decreased tear production and can cause dry eye symptoms on both sides.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for H04.143. Check the code and parent instructions in the Code Book.
Excludes 2
Official- certain conditions originating in the perinatal period (P04-P96)Inherited from H00-H59, H00-H05
- certain infectious and parasitic diseases (A00-B99)Inherited from H00-H59, H00-H05
- complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from H00-H59, H00-H05
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from H00-H59, H00-H05
- diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)Inherited from H00-H59, H00-H05
- endocrine, nutritional and metabolic diseases (E00-E88)Inherited from H00-H59, H00-H05
- injury (trauma) of eye and orbit (S05.-)Inherited from H00-H59, H00-H05
- injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from H00-H59, H00-H05
- neoplasms (C00-D49)Inherited from H00-H59, H00-H05
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from H00-H59, H00-H05
- syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)Inherited from H00-H59, H00-H05
- open wound of eyelid (S01.1-)Inherited from H00-H59, H00-H05
- superficial injury of eyelid (S00.1-, S00.2-)Inherited from H00-H59, H00-H05
Related Codes
Includes
OfficialNo Includes notes are included in this display for H04.143. Check the code and parent instructions in the Code Book.
Excludes 1
Official- congenital malformations of lacrimal system (Q10.4-Q10.6)Inherited from H04
Code First
OfficialNo Code First sequencing instructions are included in this display for H04.143. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for H04.143. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for H04.143. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is H04.143 an HCC code?
No. H04.143 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- H04.143
- Description
- Primary lacrimal gland atrophy, bilateral lacrimal glands
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
Get the V28 mapping + MEAT cheat sheet
One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.
Free PDF. No card. Unsubscribe anytime.
What This Code Means
H04.143 is the ICD-10-CM diagnosis code for primary lacrimal gland atrophy, bilateral lacrimal glands. This condition involves the shrinking or wasting away of both tear-producing glands (lacrimal glands) located near the eyes. This leads to decreased tear production and can cause dry eye symptoms on both sides. H04.143 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering disorders of eyelid, lacrimal system and orbit (h00-h05).
H04.143 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.
Verify that the atrophy affects BOTH lacrimal glands before assigning this bilateral code; if only one side is affected, use the unilateral code (H04.141) instead.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for H04.143 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify that the atrophy affects BOTH lacrimal glands before assigning this bilateral code; if only one side is affected, use the unilateral code (H04.141) instead
- •Document the underlying cause if known (such as Sjögren's syndrome, sarcoidosis, or radiation therapy), as this may require an additional diagnosis code