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H26.113

Billable

Localized traumatic opacities, bilateral

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

What This Code Means

This code describes clouding or haziness of the lens in both eyes caused by trauma or injury. The opacity (cloudiness) is limited to a specific area of the lens rather than affecting the entire lens.

Coding Tips

  • Verify that the documentation specifies bilateral involvement (both eyes) before assigning this code; if only one eye is affected, use the unilateral code H26.111 instead
  • Ensure the opacities are documented as traumatic in origin and localized to a specific region; if the trauma is recent and acute, consider also coding the external cause code (W-codes) to indicate how the injury occurred

Code Hierarchy

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