What is ICD-10 code H04.322?

H04.322 is the ICD-10-CM diagnosis code for Acute dacryocystitis of left lacrimal passage. An acute infection and inflammation of the tear drainage sac (lacrimal sac) on the left side, causing pain, swelling, and discharge. H04.322 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. H04.322 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. H04.322 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. H04.322 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does H04.322 map to under V28?

H04.322 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

What RAF reference is published for H04.322?

H04.322 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

What is the V28 vs V24 difference for H04.322?

H04.322 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

What documentation supports H04.322?

Document whether this is primary infection or secondary to obstruction of the tear duct Confirm left eye involvement is explicitly stated in the medical record H04.322 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

2026 ICD-10-CM H04.322: Acute dacryocystitis of left

H04.322 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools

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Code lookupH04.322

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of eyelid, lacrimal system and orbit (H00-H05)

H04.322

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Acute dacryocystitis of left lacrimal passage

An acute infection and inflammation of the tear drainage sac (lacrimal sac) on the left side, causing pain, swelling, and discharge.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

H04.3Acute and unspecified inflammation of lacrimal passages H04.32Acute dacryocystitis H04.322Acute dacryocystitis of left lacrimal passage

Inclusion Terms

Official

Acute dacryopericystitisInherited from H04.32

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

Official

H04.321Acute dacryocystitis of right lacrimal passage H04.323Acute dacryocystitis of bilateral lacrimal passages H04.329Acute dacryocystitis of unspecified lacrimal passage

Includes

Official

No Includes notes are included in this display for H04.322. 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, H04.3
neonatal dacryocystitis (P39.1)Inherited from H04, H04.3

Code First

Official

No Code First sequencing instructions are included in this display for H04.322. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for H04.322. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for H04.322. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Document whether this is primary infection or secondary to obstruction of the tear duct

Confirm left eye involvement is explicitly stated in the medical record

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 H04.322 an HCC code?

No. H04.322 is a billable ICD-10-CM code with no mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code: H04.322
Description: Acute dacryocystitis of left lacrimal passage
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

Coder workflow notes

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

What This Code Means

H04.322 is the ICD-10-CM diagnosis code for acute dacryocystitis of left lacrimal passage. An acute infection and inflammation of the tear drainage sac (lacrimal sac) on the left side, causing pain, swelling, and discharge. H04.322 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).

H04.322 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28 or V24 community payment models, 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.

Document whether this is primary infection or secondary to obstruction of the tear duct.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for H04.322 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document whether this is primary infection or secondary to obstruction of the tear duct
•Confirm left eye involvement is explicitly stated in the medical record