ICD-10 Code H04.563 – Stenosis of bilateral lacrimal punctum (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code H04.563 – Stenosis of bilateral lacrimal punctum
What it is
This code identifies narrowing of both lacrimal puncta, the small openings that drain tears from the eyelids into the tear drainage system. The narrowing can reduce tear outflow and contribute to tearing.
Clinical signs
Common findings include tearing, tear overflow, or a visibly narrowed punctal opening on exam. Clinical features vary; refer to documentation.
When to use this code
Use H04.563 when the provider documents bilateral punctal stenosis or bilateral narrowing of the lacrimal puncta. It fits cases where the condition is confirmed on eye examination or in an ophthalmology note. Code it only when both sides are involved and documented.
Do not use for
Do not use this code for unilateral punctal stenosis or for nonspecific tearing without documented punctal narrowing. Check documentation if the record mentions other tear drainage disorders.
Coding tip
Confirm that the documentation specifies both puncta; laterality matters for accurate code selection.