ICD-10 Code H04.5 – Stenosis and insufficiency of lacrimal passages (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code H04.5 – Stenosis and insufficiency of lacrimal passages
What it is
H04.5 identifies narrowing or inadequate function of the lacrimal drainage passages. Use it when the tear drainage system is obstructed or does not work properly, causing impaired tear outflow.
Clinical signs
Typical findings include tearing, tear overflow onto the cheek, and possible recurrent irritation around the eye. Clinical features vary; refer to documentation for the exact site and cause.
When to use this code
Use H04.5 when the record documents stenosis, narrowing, or insufficiency of the lacrimal passages as the diagnosis. It fits outpatient or specialist notes describing chronic epiphora due to drainage impairment. Code it when the provider identifies the lacrimal passages as the problem, not just watery eyes alone.
Do not use for
Do not use this code for tearing without a documented lacrimal passage disorder. Check documentation if the note instead describes infection, trauma, or another eye condition as the cause.
Coding tip
Confirm the provider names the lacrimal passages as stenotic or insufficient before assigning H04.5.