Lacrimal fistula unspecified lacrimal passage

This code describes an abnormal, pathological communication or tract involving the lacrimal drainage system, where the specific lacrimal passage affected is not documented. This fistula allows tears or lacrimal fluid to drain abnormally, often to the skin surface or into an adjacent structure.

Use this code when documentation confirms a lacrimal fistula but does not specify whether it originates from the punctum, canaliculus, lacrimal sac, or nasolacrimal duct. This typically occurs when the exact anatomical origin of the fistula has not been precisely identified or recorded by the provider.

• Avoid using this code if the specific lacrimal passage involved (e.g., canaliculus, lacrimal sac) is documented; instead, use a more specific code from the H04.6- series.
• Query the provider if the documentation indicates a lacrimal fistula but lacks specificity regarding the affected passage, to allow for more precise coding.
• This code represents an unspecified laterality; if laterality (right, left, bilateral) is documented, a more specific code should be chosen.