ICD-10 Code H04.611 – Lacrimal fistula right lacrimal passage (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code H04.611 – Lacrimal fistula right lacrimal passage
What it is
Use this code for an abnormal fistulous opening involving the right lacrimal passage. It indicates an unwanted tract connecting the lacrimal system to the skin or another surface.
Clinical signs
Typical findings include persistent tearing, a visible opening near the medial canthus, or drainage from the right lacrimal area. Clinical features vary; refer to documentation.
When to use this code
Assign H04.611 when the provider documents a lacrimal fistula specifically on the right side. Use it for congenital or acquired fistulous tracts only if the record identifies the right lacrimal passage as the source.
If the note says “lacrimal fistula” without laterality, check documentation before coding. Do not assume the side from imaging, exam, or history unless the provider states it clearly.
Do not use for
Do not use this code for simple tearing, blocked tear ducts, or nonspecific eye discharge. Check documentation if the finding is a canalicular injury, abscess, or another lacrimal disorder.
Coding tip
Always verify laterality and the exact lacrimal site in the provider note before assigning H04.611.