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H04.531

Billable

Neonatal obstruction of right nasolacrimal duct

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

What This Code Means

A blockage in the tear drainage tube (nasolacrimal duct) on the right side that occurs in newborns, preventing tears from draining properly from the eye into the nose. This causes excessive tearing and eye discharge in the affected eye.

Coding Tips

  • This code is specific to neonates (newborns) and should only be used for infants; verify the patient's age is within the neonatal period (typically 0-28 days)
  • The code specifies the RIGHT side; ensure you have confirmed laterality in the documentation, as there is a separate code (H04.532) for left-sided obstruction and H04.533 for bilateral cases

Code Hierarchy

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