ICD-10 · PDGM grouping
H26 Other cataract
All 69 codes in the H26 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
69
Can lead a claim
48
Cannot lead a claim
21
What CMS assigns to H26
48 of the 69 codes group to MMTA - Other; 21 are assigned no clinical group. None of the 69 is assigned a comorbidity subgroup. 48 of the 69 can lead a claim. CMS attaches a code-first note to 4 of the 69.
Code first
CMS grouper convention 49, on H26.231, H26.232, H26.233, H26.239. Code first:
- underlying glaucoma (H40-H42)
Every code in H26
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 |
|---|---|---|---|---|
| H26.0 Infantile and juvenile cataract | ||||
| H26.00 Unspecified infantile and juvenile cataract | ||||
| H26.001 | Unspecified infantile and juvenile cataract, right eye | Can lead a claim | A | None |
| H26.002 | Unspecified infantile and juvenile cataract, left eye | Can lead a claim | A | None |
| H26.003 | Unspecified infantile and juvenile cataract, bilateral | Can lead a claim | A | None |
| H26.009 | Unspecified infantile and juvenile cataract, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.01 Infantile and juvenile cortical, lamellar, or zonular cataract | ||||
| H26.011 | Infantile and juvenile cortical, lamellar, or zonular cataract, right eyeCMS: Infantile and juv cortical/lamellar/zonular cataract, r eye | Can lead a claim | A | None |
| H26.012 | Infantile and juvenile cortical, lamellar, or zonular cataract, left eyeCMS: Infantile and juv cortical/lamellar/zonular cataract, l eye | Can lead a claim | A | None |
| H26.013 | Infantile and juvenile cortical, lamellar, or zonular cataract, bilateralCMS: Infantile and juv cortical/lamellar/zonular cataract, bi | Can lead a claim | A | None |
| H26.019 | Infantile and juvenile cortical, lamellar, or zonular cataract, unspecified eyeCMS: Infantile & juv cortical/lamellar/zonular cataract, unsp eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.03 Infantile and juvenile nuclear cataract | ||||
| H26.031 | Infantile and juvenile nuclear cataract, right eye | Can lead a claim | A | None |
| H26.032 | Infantile and juvenile nuclear cataract, left eye | Can lead a claim | A | None |
| H26.033 | Infantile and juvenile nuclear cataract, bilateral | Can lead a claim | A | None |
| H26.039 | Infantile and juvenile nuclear cataract, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.04 Anterior subcapsular polar infantile and juvenile cataract | ||||
| H26.041 | Anterior subcapsular polar infantile and juvenile cataract, right eyeCMS: Ant subcapsular polar infantile and juvenile cataract, r eye | Can lead a claim | A | None |
| H26.042 | Anterior subcapsular polar infantile and juvenile cataract, left eyeCMS: Ant subcapsular polar infantile and juv cataract, left eye | Can lead a claim | A | None |
| H26.043 | Anterior subcapsular polar infantile and juvenile cataract, bilateralCMS: Ant subcapsular polar infantile and juvenile cataract, bi | Can lead a claim | A | None |
| H26.049 | Anterior subcapsular polar infantile and juvenile cataract, unspecified eyeCMS: Ant subcapsular polar infantile and juv cataract, unsp eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.05 Posterior subcapsular polar infantile and juvenile cataract | ||||
| H26.051 | Posterior subcapsular polar infantile and juvenile cataract, right eyeCMS: Post subcapsular polar infantile and juv cataract, r eye | Can lead a claim | A | None |
| H26.052 | Posterior subcapsular polar infantile and juvenile cataract, left eyeCMS: Post subcapsular polar infantile and juv cataract, left eye | Can lead a claim | A | None |
| H26.053 | Posterior subcapsular polar infantile and juvenile cataract, bilateralCMS: Post subcapsular polar infantile and juvenile cataract, bi | Can lead a claim | A | None |
| H26.059 | Posterior subcapsular polar infantile and juvenile cataract, unspecified eyeCMS: Post subcapsular polar infantile and juv cataract, unsp eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.06 Combined forms of infantile and juvenile cataract | ||||
| H26.061 | Combined forms of infantile and juvenile cataract, right eye | Can lead a claim | A | None |
| H26.062 | Combined forms of infantile and juvenile cataract, left eye | Can lead a claim | A | None |
| H26.063 | Combined forms of infantile and juvenile cataract, bilateral | Can lead a claim | A | None |
| H26.069 | Combined forms of infantile and juvenile cataract, unspecified eyeCMS: Combined forms of infantile and juvenile cataract, unsp eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.09 | Other infantile and juvenile cataract | Can lead a claim | A | None |
| H26.1 Traumatic cataract | ||||
| H26.10 Unspecified traumatic cataract | ||||
| H26.101 | Unspecified traumatic cataract, right eye | Can lead a claim | A | None |
| H26.102 | Unspecified traumatic cataract, left eye | Can lead a claim | A | None |
| H26.103 | Unspecified traumatic cataract, bilateral | Can lead a claim | A | None |
| H26.109 | Unspecified traumatic cataract, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.11 Localized traumatic opacities | ||||
| H26.111 | Localized traumatic opacities, right eye | Can lead a claim | A | None |
| H26.112 | Localized traumatic opacities, left eye | Can lead a claim | A | None |
| H26.113 | Localized traumatic opacities, bilateral | Can lead a claim | A | None |
| H26.119 | Localized traumatic opacities, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.12 Partially resolved traumatic cataract | ||||
| H26.121 | Partially resolved traumatic cataract, right eye | Can lead a claim | A | None |
| H26.122 | Partially resolved traumatic cataract, left eye | Can lead a claim | A | None |
| H26.123 | Partially resolved traumatic cataract, bilateral | Can lead a claim | A | None |
| H26.129 | Partially resolved traumatic cataract, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.13 Total traumatic cataract | ||||
| H26.131 | Total traumatic cataract, right eye | Can lead a claim | A | None |
| H26.132 | Total traumatic cataract, left eye | Can lead a claim | A | None |
| H26.133 | Total traumatic cataract, bilateral | Can lead a claim | A | None |
| H26.139 | Total traumatic cataract, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.2 Complicated cataract | ||||
| H26.20 | Unspecified complicated cataract | Can lead a claim | A | None |
| H26.21 Cataract with neovascularization | ||||
| H26.211 | Cataract with neovascularization, right eye | Can lead a claim | A | None |
| H26.212 | Cataract with neovascularization, left eye | Can lead a claim | A | None |
| H26.213 | Cataract with neovascularization, bilateral | Can lead a claim | A | None |
| H26.219 | Cataract with neovascularization, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.22 Cataract secondary to ocular disorders (degenerative) (inflammatory) | ||||
| H26.221 | Cataract secondary to ocular disorders (degenerative) (inflammatory), right eyeCMS: Cataract secondary to ocular disorders, right eye | Can lead a claim | A | None |
| H26.222 | Cataract secondary to ocular disorders (degenerative) (inflammatory), left eyeCMS: Cataract secondary to ocular disorders, left eye | Can lead a claim | A | None |
| H26.223 | Cataract secondary to ocular disorders (degenerative) (inflammatory), bilateralCMS: Cataract secondary to ocular disorders, bilateral | Can lead a claim | A | None |
| H26.229 | Cataract secondary to ocular disorders (degenerative) (inflammatory), unspecified eyeCMS: Cataract secondary to ocular disorders, unsp eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.23 Glaucomatous flecks (subcapsular) | ||||
| H26.231 | Glaucomatous flecks (subcapsular), right eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.232 | Glaucomatous flecks (subcapsular), left eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.233 | Glaucomatous flecks (subcapsular), bilateral | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.239 | Glaucomatous flecks (subcapsular), unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.3 Drug-induced cataract | ||||
| H26.30 | Drug-induced cataract, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.31 | Drug-induced cataract, right eye | Can lead a claim | A | None |
| H26.32 | Drug-induced cataract, left eye | Can lead a claim | A | None |
| H26.33 | Drug-induced cataract, bilateral | Can lead a claim | A | None |
| H26.4 Secondary cataract | ||||
| H26.40 | Unspecified secondary cataract | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.41 Soemmering's ring | ||||
| H26.411 | Soemmering's ring, right eye | Can lead a claim | A | None |
| H26.412 | Soemmering's ring, left eye | Can lead a claim | A | None |
| H26.413 | Soemmering's ring, bilateral | Can lead a claim | A | None |
| H26.419 | Soemmering's ring, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.49 Other secondary cataract | ||||
| H26.491 | Other secondary cataract, right eye | Can lead a claim | A | None |
| H26.492 | Other secondary cataract, left eye | Can lead a claim | A | None |
| H26.493 | Other secondary cataract, bilateral | Can lead a claim | A | None |
| H26.499 | Other secondary cataract, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H26.8 | Other specified cataract | Can lead a claim | A | None |
| H26.9 | Unspecified cataract | 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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