H04.69 Other changes of lacrimal passages

ICD-10-CM Code H04.69: Other Changes of Lacrimal Passages

ICD-10-CM code H04.69 is designated for "Other changes of lacrimal passages." Public sources list this diagnosis code alongside related conditions such as lacrimal passage granulomas. Clinical literature describes various structural changes within the lacrimal drainage system, including stenosis, fibrotic membranes, and false passages, which may occur in areas like the lacrimal sac or nasolacrimal duct. 2 3 4

Plain-language overview

The diagnosis code H04.69 is officially labeled as "Other changes of lacrimal passages" in coding references. This code is listed alongside other specific lacrimal conditions, such as granuloma of the lacrimal passage. 3 4

What this code represents

Code H04.69 is categorized under disorders of the lacrimal system, and payer coding lists distinguish it from other specified conditions like H04.89 and granuloma codes. The supplied sources establish this code's title and its placement among related ocular diagnosis codes. 3 4

Clinical context

Clinical literature notes that structural changes in the lacrimal drainage system include stenosis and fibrotic membranes. False passages, which are accompanied by these structural changes, can occur in various locations including the canaliculus, lacrimal sac, and nasolacrimal duct. 2

Inflammation of the lacrimal sac, known as dacryocystitis, is caused by obstruction of the nasolacrimal duct leading to tear stagnation. Chronic distension of the lacrimal sac may cause acquired sacculations or diverticulum formation, with spread of the disease into adjacent tissues. 1

Documentation considerations

Clinical evaluations of lacrimal drainage system issues document findings such as stenosis, fibrotic membranes, mucus, stones, and granulation. Dacryoendoscopy findings further distinguish between structural changes and secretory changes within the lacrimal duct. 2

Coverage and utilization context

The Centers for Medicare and Medicaid Services includes code H04.69 in a billing and coding article for ocular photography. This code's appearance in a payer article provides operational context for administrative billing, but the supplied text does not confirm reimbursement guarantees. 3

What the sources add

While clinical literature describes structural changes and conditions of the lacrimal drainage system, payer sources list the specific billing code H04.69. Comparing these domains shows that clinical findings of lacrimal changes correspond to distinct diagnosis codes used for administrative purposes. 2 3

The clinical source details specific structural changes like false passages and diverticulum formation, whereas the payer sources provide the official diagnostic label for other changes of the lacrimal passages. Together, these sources provide clinical descriptions and operational coding utility. 1 2 3

Sources

1. Bookshelf — ncbi.nlm.nih.gov; accessed 2026-07-25.
2. The technique and its role of dacryoendoscopy in the management of the false passage of the lacrimal drainage system — pmc.ncbi.nlm.nih.gov; accessed 2026-07-25.
3. Article - Billing and Coding: Ocular Photography - External (A57068) — cms.gov; accessed 2026-07-25.
4. Provider Resource Center — prc.hmsa.com; accessed 2026-07-25.