Coding and coverage · ICD-10-CM
Instructional notes
Chapter 7
Excludes2Not included here: the patient may have both; report both when both are present.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury (trauma) of eye and orbit (S05.-)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
- syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)
Notes
- Use an external cause code following the code for the eye condition, if applicable, to identify the cause of the eye condition
H54
Excludes1Not coded here: never report with this code, except when the two conditions are unrelated.
- amaurosis fugax (G45.3)
Code firstSequence the underlying condition first.
- any associated underlying cause of the blindness
Notes
- For definition of visual impairment categories see table below
This code
Excludes1Not coded here: never report with this code, except when the two conditions are unrelated.
Inclusion terms
- Blindness NOS according to USA definition
Notes
- The table below gives a classification of severity of visual impairment recommended by a WHO Study Group on the Prevention of Blindness, Geneva, 6-10 November 1972.
- The term 'low vision' in category H54 comprises categories 1 and 2 of the table, the term 'blindness' categories 3, 4 and 5, and the term 'unqualified visual loss' category 9.
- If the extent of the visual field is taken into account, patients with a field no greater than 10 but greater than 5 around central fixation should be placed in category 3 and patients with a field no greater than 5 around central fixation should be placed in category 4, even if the central acuity is not impaired.
Chapter 7: Diseases of the eye and adnexa · H53-H54 Visual disturbances and blindness (H53-H54)
Source: ICD-10-CM FY 2027 code descriptions and tabular list (CMS and CDC National Center for Health Statistics), effective 2026-10-01 through 2027-09-30 · CMS ICD-10 files. HCC mapping: CMS-HCC V28, payment year 2027. As of 2026-11-04.
Coverage and payment depend on the claim details; confirm with the Medicare Administrative Contractor.