ICD-10 Code H16.04 – Marginal corneal ulcer (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code H16.04 – Marginal corneal ulcer
What it is
H16.04 identifies a marginal corneal ulcer, an inflammatory corneal lesion near the edge of the cornea. It usually reflects peripheral corneal involvement and should be documented precisely.
Clinical signs
Typical findings include a peripheral corneal ulcer, localized redness, pain, tearing, and possible photophobia. Clinical features vary; refer to documentation.
When to use this code
Use H16.04 when the provider documents a marginal corneal ulcer or equivalent peripheral corneal ulcer diagnosis. Code it when the record clearly identifies the condition rather than a nonspecific keratitis or conjunctival disorder. Check documentation if the note only describes corneal irritation or abrasion.
Do not use for
Do not use this code for corneal abrasion, nonspecific corneal ulceration, or eye redness without a documented ulcer. If the diagnosis is uncertain, check documentation.
Coding tip
Confirm that the ulcer is specifically described as marginal or peripheral before assigning H16.04.