ICD-10 · PDGM grouping
H21 Other disorders of iris and ciliary body
All 97 codes in the H21 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
ICD-10-CM FY2027 · CMS grouper v07.2.26
Codes in family
97
Can lead a claim
73
Cannot lead a claim
24
What CMS assigns to H21
73 of the 97 codes group to MMTA - Other; 24 are assigned no clinical group. None of the 97 is assigned a comorbidity subgroup. 73 of the 97 can lead a claim.
Every code in H21
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| H21.0 Hyphema | ||||
| H21.00 | Hyphema, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.01 | Hyphema, right eye | Can lead a claim | A | None |
| H21.02 | Hyphema, left eye | Can lead a claim | A | None |
| H21.03 | Hyphema, bilateral | Can lead a claim | A | None |
| H21.1 Other vascular disorders of iris and ciliary body | ||||
| H21.1X Other vascular disorders of iris and ciliary body | ||||
| H21.1X1 | Other vascular disorders of iris and ciliary body, right eye | Can lead a claim | A | None |
| H21.1X2 | Other vascular disorders of iris and ciliary body, left eye | Can lead a claim | A | None |
| H21.1X3 | Other vascular disorders of iris and ciliary body, bilateral | Can lead a claim | A | None |
| H21.1X9 | Other vascular disorders of iris and ciliary body, unspecified eyeCMS: Other vascular disorders of iris and ciliary body, unsp eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.2 Degeneration of iris and ciliary body | ||||
| H21.21 Degeneration of chamber angle | ||||
| H21.211 | Degeneration of chamber angle, right eye | Can lead a claim | A | None |
| H21.212 | Degeneration of chamber angle, left eye | Can lead a claim | A | None |
| H21.213 | Degeneration of chamber angle, bilateral | Can lead a claim | A | None |
| H21.219 | Degeneration of chamber angle, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.22 Degeneration of ciliary body | ||||
| H21.221 | Degeneration of ciliary body, right eye | Can lead a claim | A | None |
| H21.222 | Degeneration of ciliary body, left eye | Can lead a claim | A | None |
| H21.223 | Degeneration of ciliary body, bilateral | Can lead a claim | A | None |
| H21.229 | Degeneration of ciliary body, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.23 Degeneration of iris (pigmentary) | ||||
| H21.231 | Degeneration of iris (pigmentary), right eye | Can lead a claim | A | None |
| H21.232 | Degeneration of iris (pigmentary), left eye | Can lead a claim | A | None |
| H21.233 | Degeneration of iris (pigmentary), bilateral | Can lead a claim | A | None |
| H21.239 | Degeneration of iris (pigmentary), unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.24 Degeneration of pupillary margin | ||||
| H21.241 | Degeneration of pupillary margin, right eye | Can lead a claim | A | None |
| H21.242 | Degeneration of pupillary margin, left eye | Can lead a claim | A | None |
| H21.243 | Degeneration of pupillary margin, bilateral | Can lead a claim | A | None |
| H21.249 | Degeneration of pupillary margin, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.25 Iridoschisis | ||||
| H21.251 | Iridoschisis, right eye | Can lead a claim | A | None |
| H21.252 | Iridoschisis, left eye | Can lead a claim | A | None |
| H21.253 | Iridoschisis, bilateral | Can lead a claim | A | None |
| H21.259 | Iridoschisis, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.26 Iris atrophy (essential) (progressive) | ||||
| H21.261 | Iris atrophy (essential) (progressive), right eye | Can lead a claim | A | None |
| H21.262 | Iris atrophy (essential) (progressive), left eye | Can lead a claim | A | None |
| H21.263 | Iris atrophy (essential) (progressive), bilateral | Can lead a claim | A | None |
| H21.269 | Iris atrophy (essential) (progressive), unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.27 Miotic pupillary cyst | ||||
| H21.271 | Miotic pupillary cyst, right eye | Can lead a claim | A | None |
| H21.272 | Miotic pupillary cyst, left eye | Can lead a claim | A | None |
| H21.273 | Miotic pupillary cyst, bilateral | Can lead a claim | A | None |
| H21.279 | Miotic pupillary cyst, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.29 | Other iris atrophy | Can lead a claim | A | None |
| H21.3 Cyst of iris, ciliary body and anterior chamber | ||||
| H21.30 Idiopathic cysts of iris, ciliary body or anterior chamber | ||||
| H21.301 | Idiopathic cysts of iris, ciliary body or anterior chamber, right eyeCMS: Idio cysts of iris, ciliary body or ant chamber, right eye | Can lead a claim | A | None |
| H21.302 | Idiopathic cysts of iris, ciliary body or anterior chamber, left eyeCMS: Idio cysts of iris, ciliary body or ant chamber, left eye | Can lead a claim | A | None |
| H21.303 | Idiopathic cysts of iris, ciliary body or anterior chamber, bilateralCMS: Idio cysts of iris, ciliary body or ant chamber, bilateral | Can lead a claim | A | None |
| H21.309 | Idiopathic cysts of iris, ciliary body or anterior chamber, unspecified eyeCMS: Idio cysts of iris, ciliary body or ant chamber, unsp eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.31 Exudative cysts of iris or anterior chamber | ||||
| H21.311 | Exudative cysts of iris or anterior chamber, right eye | Can lead a claim | A | None |
| H21.312 | Exudative cysts of iris or anterior chamber, left eye | Can lead a claim | A | None |
| H21.313 | Exudative cysts of iris or anterior chamber, bilateral | Can lead a claim | A | None |
| H21.319 | Exudative cysts of iris or anterior chamber, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.32 Implantation cysts of iris, ciliary body or anterior chamber | ||||
| H21.321 | Implantation cysts of iris, ciliary body or anterior chamber, right eyeCMS: Implant cysts of iris, ciliary body or ant chamber, r eye | Can lead a claim | A | None |
| H21.322 | Implantation cysts of iris, ciliary body or anterior chamber, left eyeCMS: Implant cysts of iris, ciliary body or ant chamber, left eye | Can lead a claim | A | None |
| H21.323 | Implantation cysts of iris, ciliary body or anterior chamber, bilateralCMS: Implant cysts of iris, ciliary body or ant chamber, bi | Can lead a claim | A | None |
| H21.329 | Implantation cysts of iris, ciliary body or anterior chamber, unspecified eyeCMS: Implant cysts of iris, ciliary body or ant chamber, unsp eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.33 Parasitic cyst of iris, ciliary body or anterior chamber | ||||
| H21.331 | Parasitic cyst of iris, ciliary body or anterior chamber, right eyeCMS: Parastc cyst of iris, ciliary body or ant chamber, right eye | Can lead a claim | A | None |
| H21.332 | Parasitic cyst of iris, ciliary body or anterior chamber, left eyeCMS: Parastc cyst of iris, ciliary body or ant chamber, left eye | Can lead a claim | A | None |
| H21.333 | Parasitic cyst of iris, ciliary body or anterior chamber, bilateralCMS: Parasitic cyst of iris, ciliary body or ant chamber, bi | Can lead a claim | A | None |
| H21.339 | Parasitic cyst of iris, ciliary body or anterior chamber, unspecified eyeCMS: Parastc cyst of iris, ciliary body or ant chamber, unsp eye | Cannot lead a claimUnspecified diagnosis code not acceptable as principal diagnosis since there is a more specific code available that would further accurately identify the condition | None | None |
| H21.34 Primary cyst of pars plana | ||||
| H21.341 | Primary cyst of pars plana, right eye | Can lead a claim | A | None |
| H21.342 | Primary cyst of pars plana, left eye | Can lead a claim | A | None |
| H21.343 | Primary cyst of pars plana, bilateral | Can lead a claim | A | None |
| H21.349 | Primary cyst of pars plana, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.35 Exudative cyst of pars plana | ||||
| H21.351 | Exudative cyst of pars plana, right eye | Can lead a claim | A | None |
| H21.352 | Exudative cyst of pars plana, left eye | Can lead a claim | A | None |
| H21.353 | Exudative cyst of pars plana, bilateral | Can lead a claim | A | None |
| H21.359 | Exudative cyst of pars plana, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.4 Pupillary membranes | ||||
| H21.40 | Pupillary membranes, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.41 | Pupillary membranes, right eye | Can lead a claim | A | None |
| H21.42 | Pupillary membranes, left eye | Can lead a claim | A | None |
| H21.43 | Pupillary membranes, bilateral | Can lead a claim | A | None |
| H21.5 Other and unspecified adhesions and disruptions of iris and ciliary body | ||||
| H21.50 Unspecified adhesions of iris | ||||
| H21.501 | Unspecified adhesions of iris, right eye | Can lead a claim | A | None |
| H21.502 | Unspecified adhesions of iris, left eye | Can lead a claim | A | None |
| H21.503 | Unspecified adhesions of iris, bilateral | Can lead a claim | A | None |
| H21.509 | Unspecified adhesions of iris and ciliary body, unspecified eyeCMS: Unsp adhesions of iris and ciliary body, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.51 Anterior synechiae (iris) | ||||
| H21.511 | Anterior synechiae (iris), right eye | Can lead a claim | A | None |
| H21.512 | Anterior synechiae (iris), left eye | Can lead a claim | A | None |
| H21.513 | Anterior synechiae (iris), bilateral | Can lead a claim | A | None |
| H21.519 | Anterior synechiae (iris), unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.52 Goniosynechiae | ||||
| H21.521 | Goniosynechiae, right eye | Can lead a claim | A | None |
| H21.522 | Goniosynechiae, left eye | Can lead a claim | A | None |
| H21.523 | Goniosynechiae, bilateral | Can lead a claim | A | None |
| H21.529 | Goniosynechiae, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.53 Iridodialysis | ||||
| H21.531 | Iridodialysis, right eye | Can lead a claim | A | None |
| H21.532 | Iridodialysis, left eye | Can lead a claim | A | None |
| H21.533 | Iridodialysis, bilateral | Can lead a claim | A | None |
| H21.539 | Iridodialysis, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.54 Posterior synechiae (iris) | ||||
| H21.541 | Posterior synechiae (iris), right eye | Can lead a claim | A | None |
| H21.542 | Posterior synechiae (iris), left eye | Can lead a claim | A | None |
| H21.543 | Posterior synechiae (iris), bilateral | Can lead a claim | A | None |
| H21.549 | Posterior synechiae (iris), unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.55 Recession of chamber angle | ||||
| H21.551 | Recession of chamber angle, right eye | Can lead a claim | A | None |
| H21.552 | Recession of chamber angle, left eye | Can lead a claim | A | None |
| H21.553 | Recession of chamber angle, bilateral | Can lead a claim | A | None |
| H21.559 | Recession of chamber angle, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.56 Pupillary abnormalities | ||||
| H21.561 | Pupillary abnormality, right eye | Can lead a claim | A | None |
| H21.562 | Pupillary abnormality, left eye | Can lead a claim | A | None |
| H21.563 | Pupillary abnormality, bilateral | Can lead a claim | A | None |
| H21.569 | Pupillary abnormality, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H21.8 Other specified disorders of iris and ciliary body | ||||
| H21.81 | Floppy iris syndrome | Can lead a claim | A | None |
| H21.82 | Plateau iris syndrome (post-iridectomy) (postprocedural) | Can lead a claim | A | None |
| H21.89 | Other specified disorders of iris and ciliary body | Can lead a claim | A | None |
| H21.9 | Unspecified disorder of iris and ciliary body | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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