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H26 ICD-10-CM Code: Other cataract

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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of lens (H25-H28)

H26

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Other cataract

Other cataract

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
H2Disorders of lens (H25-H28)
H26Other cataract

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H26 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H26 in this effective period.

Related Child Codes

Official
H26.0Infantile and juvenile cataract
H26.1Traumatic cataract
H26.2Complicated cataract
H26.3Drug-induced cataract
H26.4Secondary cataract

Includes

Official

ICD-10-CM does not list Includes notes for H26 in this effective period.

Excludes 1

Official
  • congenital cataract (Q12.0)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H26 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H26 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H26 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

What This Code Means

H26 is the ICD-10-CM diagnosis code for other cataract. H26 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering disorders of lens (h25-h28).

Header codes like H26 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at H26's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H26 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

  • congenital cataract (Q12.0)

Child Codes

Code Hierarchy

H26Other cataract
H26Other cataract

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