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H04.319

Billable

Phlegmonous dacryocystitis of unspecified lacrimal passage

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

What This Code Means

A severe spreading infection of the tear drainage system with inflammation and pus formation, but the specific side (left, right, or both) is not specified in the medical record.

Coding Tips

  • Use this code only when laterality cannot be determined from documentation; query provider if possible for specificity
  • This is a less specific code; attempt to obtain laterality information before finalizing the claim

Code Hierarchy

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