H26.011
BillableInfantile and juvenile cortical, lamellar, or zonular cataract, right eye
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
A clouding of the lens in the right eye that develops in infants or children, affecting the outer layers (cortical), middle ring (lamellar), or zones of the lens. This condition impairs vision and typically requires medical evaluation and possible surgical intervention.
Coding Tips
- •Always verify laterality (right eye, left eye, or bilateral) as the code specifically indicates right eye (011); use H26.012 for left eye and H26.013 for bilateral cases
- •Distinguish between infantile/juvenile cataracts (H26.01) and other cataract types; document the specific morphology (cortical, lamellar, or zonular) in the medical record to support accurate code selection
Code Hierarchy
└H26Other cataract└H26.0Infantile and juvenile cataract└H26.01Infantile and juvenile cortical, lamellar, or zonular cataract└H26.011Infantile and juvenile cortical, lamellar, or zonular cataract, right eye
└H26.011Infantile and juvenile cortical, lamellar, or zonular cataract, right eye