Chapter 7: Diseases of the eye and adnexa (H00–H59)

227 diagnoses listed as covered by Medicare billing and coding articles for HCPCS Level II codes. All chapters.

H02: Other disorders of eyelid

• H02.041 — Spastic entropion of right upper eyelid
• H02.042 — Spastic entropion of right lower eyelid
• H02.044 — Spastic entropion of left upper eyelid
• H02.045 — Spastic entropion of left lower eyelid
• H02.141 — Spastic ectropion of right upper eyelid
• H02.142 — Spastic ectropion of right lower eyelid
• H02.144 — Spastic ectropion of left upper eyelid
• H02.145 — Spastic ectropion of left lower eyelid
• H02.431 — Paralytic ptosis of right eyelid
• H02.432 — Paralytic ptosis of left eyelid
• H02.433 — Paralytic ptosis of bilateral eyelids

H34: Retinal vascular occlusions

• H34.01 — Transient retinal artery occlusion, right eye
• H34.02 — Transient retinal artery occlusion, left eye
• H34.03 — Transient retinal artery occlusion, bilateral
• H34.11 — Central retinal artery occlusion, right eye
• H34.12 — Central retinal artery occlusion, left eye
• H34.13 — Central retinal artery occlusion, bilateral
• H34.211 — Partial retinal artery occlusion, right eye
• H34.212 — Partial retinal artery occlusion, left eye
• H34.213 — Partial retinal artery occlusion, bilateral
• H34.231 — Retinal artery branch occlusion, right eye
• H34.232 — Retinal artery branch occlusion, left eye
• H34.233 — Retinal artery branch occlusion, bilateral
• H34.8110 — Central retinal vein occlusion, right eye, with macular edema
• H34.8111 — Central retinal vein occlusion, right eye, with retinal…
• H34.8112 — Central retinal vein occlusion, right eye, stable
• H34.8120 — Central retinal vein occlusion, left eye, with macular edema
• H34.8121 — Central retinal vein occlusion, left eye, with retinal…
• H34.8122 — Central retinal vein occlusion, left eye, stable
• H34.8130 — Central retinal vein occlusion, bilateral, with macular edema
• H34.8131 — Central retinal vein occlusion, bilateral, with retinal…
• H34.8132 — Central retinal vein occlusion, bilateral, stable
• H34.821 — Venous engorgement, right eye
• H34.822 — Venous engorgement, left eye
• H34.823 — Venous engorgement, bilateral
• H34.8310 — Tributary (branch) retinal vein occlusion, right eye, with macular…
• H34.8311 — Tributary (branch) retinal vein occlusion, right eye, with retinal…
• H34.8312 — Tributary (branch) retinal vein occlusion, right eye, stable
• H34.8320 — Tributary (branch) retinal vein occlusion, left eye, with macular…
• H34.8321 — Tributary (branch) retinal vein occlusion, left eye, with retinal…
• H34.8322 — Tributary (branch) retinal vein occlusion, left eye, stable
• H34.8330 — Tributary (branch) retinal vein occlusion, bilateral, with macular…
• H34.8331 — Tributary (branch) retinal vein occlusion, bilateral, with retinal…
• H34.8332 — Tributary (branch) retinal vein occlusion, bilateral, stable
• H34.9 — Unspecified retinal vascular occlusion

H35: Other retinal disorders

• H35.051 — Retinal neovascularization, unspecified, right eye
• H35.052 — Retinal neovascularization, unspecified, left eye
• H35.053 — Retinal neovascularization, unspecified, bilateral
• H35.3210 — Exudative age-related macular degeneration, right eye, stage…
• H35.3211 — Exudative age-related macular degeneration, right eye, with active…
• H35.3212 — Exudative age-related macular degeneration, right eye, with inactive…
• H35.3213 — Exudative age-related macular degeneration, right eye, with inactive…
• H35.3220 — Exudative age-related macular degeneration, left eye, stage…
• H35.3221 — Exudative age-related macular degeneration, left eye, with active…
• H35.3222 — Exudative age-related macular degeneration, left eye, with inactive…
• H35.3223 — Exudative age-related macular degeneration, left eye, with inactive…
• H35.3230 — Exudative age-related macular degeneration, bilateral, stage…
• H35.3231 — Exudative age-related macular degeneration, bilateral, with active…
• H35.3232 — Exudative age-related macular degeneration, bilateral, with inactive…
• H35.3233 — Exudative age-related macular degeneration, bilateral, with inactive…
• H35.351 — Cystoid macular degeneration, right eye
• H35.352 — Cystoid macular degeneration, left eye
• H35.353 — Cystoid macular degeneration, bilateral
• H35.81 — Retinal edema

H40: Glaucoma

• H40.841 — Neovascular secondary angle closure glaucoma, right eye
• H40.842 — Neovascular secondary angle closure glaucoma, left eye
• H40.843 — Neovascular secondary angle closure glaucoma, bilateral

H44: Disorders of globe

• H44.2A1 — Degenerative myopia with choroidal neovascularization, right eye
• H44.2A2 — Degenerative myopia with choroidal neovascularization, left eye
• H44.2A3 — Degenerative myopia with choroidal neovascularization, bilateral

H47: Other disorders of optic [2nd] nerve and visual pathways

• H47.11 — Papilledema associated with increased intracranial pressure
• H47.41 — Disorders of optic chiasm in (due to) inflammatory disorders
• H47.42 — Disorders of optic chiasm in (due to) neoplasm
• H47.43 — Disorders of optic chiasm in (due to) vascular disorders
• H47.49 — Disorders of optic chiasm in (due to) other disorders
• H47.531 — Disorders of visual pathways in (due to) vascular disorders, right…
• H47.532 — Disorders of visual pathways in (due to) vascular disorders, left side
• H47.631 — Disorders of visual cortex in (due to) neoplasm, right side of brain
• H47.632 — Disorders of visual cortex in (due to) neoplasm, left side of brain
• H47.641 — Disorders of visual cortex in (due to) vascular disorders, right…
• H47.642 — Disorders of visual cortex in (due to) vascular disorders, left side…

H49: Paralytic strabismus

• H49.01 — Third [oculomotor] nerve palsy, right eye
• H49.02 — Third [oculomotor] nerve palsy, left eye
• H49.03 — Third [oculomotor] nerve palsy, bilateral
• H49.11 — Fourth [trochlear] nerve palsy, right eye
• H49.12 — Fourth [trochlear] nerve palsy, left eye
• H49.13 — Fourth [trochlear] nerve palsy, bilateral
• H49.21 — Sixth [abducent] nerve palsy, right eye
• H49.22 — Sixth [abducent] nerve palsy, left eye
• H49.23 — Sixth [abducent] nerve palsy, bilateral
• H49.31 — Total (external) ophthalmoplegia, right eye
• H49.32 — Total (external) ophthalmoplegia, left eye
• H49.33 — Total (external) ophthalmoplegia, bilateral
• H49.41 — Progressive external ophthalmoplegia, right eye
• H49.42 — Progressive external ophthalmoplegia, left eye
• H49.43 — Progressive external ophthalmoplegia, bilateral
• H49.881 — Other paralytic strabismus, right eye
• H49.882 — Other paralytic strabismus, left eye
• H49.883 — Other paralytic strabismus, bilateral
• H49.9 — Unspecified paralytic strabismus

H50: Other strabismus

• H50.00 — Unspecified esotropia
• H50.011 — Monocular esotropia, right eye
• H50.012 — Monocular esotropia, left eye
• H50.021 — Monocular esotropia with A pattern, right eye
• H50.022 — Monocular esotropia with A pattern, left eye
• H50.031 — Monocular esotropia with V pattern, right eye
• H50.032 — Monocular esotropia with V pattern, left eye
• H50.041 — Monocular esotropia with other noncomitancies, right eye
• H50.042 — Monocular esotropia with other noncomitancies, left eye
• H50.05 — Alternating esotropia
• H50.06 — Alternating esotropia with A pattern
• H50.07 — Alternating esotropia with V pattern
• H50.08 — Alternating esotropia with other noncomitancies
• H50.10 — Unspecified exotropia
• H50.111 — Monocular exotropia, right eye
• H50.112 — Monocular exotropia, left eye
• H50.121 — Monocular exotropia with A pattern, right eye
• H50.122 — Monocular exotropia with A pattern, left eye
• H50.131 — Monocular exotropia with V pattern, right eye
• H50.132 — Monocular exotropia with V pattern, left eye
• H50.141 — Monocular exotropia with other noncomitancies, right eye
• H50.142 — Monocular exotropia with other noncomitancies, left eye
• H50.15 — Alternating exotropia
• H50.16 — Alternating exotropia with A pattern
• H50.17 — Alternating exotropia with V pattern
• H50.18 — Alternating exotropia with other noncomitancies
• H50.21 — Vertical strabismus, right eye
• H50.22 — Vertical strabismus, left eye
• H50.30 — Unspecified intermittent heterotropia
• H50.311 — Intermittent monocular esotropia, right eye
• H50.312 — Intermittent monocular esotropia, left eye
• H50.32 — Intermittent alternating esotropia
• H50.331 — Intermittent monocular exotropia, right eye
• H50.332 — Intermittent monocular exotropia, left eye
• H50.34 — Intermittent alternating exotropia
• H50.40 — Unspecified heterotropia
• H50.411 — Cyclotropia, right eye
• H50.412 — Cyclotropia, left eye
• H50.42 — Monofixation syndrome
• H50.43 — Accommodative component in esotropia
• H50.50 — Unspecified heterophoria
• H50.51 — Esophoria
• H50.52 — Exophoria
• H50.53 — Vertical heterophoria
• H50.54 — Cyclophoria
• H50.55 — Alternating heterophoria
• H50.60 — Mechanical strabismus, unspecified
• H50.611 — Brown's sheath syndrome, right eye
• H50.612 — Brown's sheath syndrome, left eye
• H50.621 — Inferior oblique muscle entrapment, right eye
• H50.622 — Inferior oblique muscle entrapment, left eye
• H50.631 — Inferior rectus muscle entrapment, right eye
• H50.632 — Inferior rectus muscle entrapment, left eye
• H50.641 — Lateral rectus muscle entrapment, right eye
• H50.642 — Lateral rectus muscle entrapment, left eye
• H50.651 — Medial rectus muscle entrapment, right eye
• H50.652 — Medial rectus muscle entrapment, left eye
• H50.661 — Superior oblique muscle entrapment, right eye
• H50.662 — Superior oblique muscle entrapment, left eye
• H50.671 — Superior rectus muscle entrapment, right eye
• H50.672 — Superior rectus muscle entrapment, left eye
• H50.681 — Extraocular muscle entrapment, unspecified, right eye
• H50.682 — Extraocular muscle entrapment, unspecified, left eye
• H50.69 — Other mechanical strabismus
• H50.811 — Duane's syndrome, right eye
• H50.812 — Duane's syndrome, left eye
• H50.89 — Other specified strabismus
• H50.9 — Unspecified strabismus

H51: Other disorders of binocular movement

• H51.0 — Palsy (spasm) of conjugate gaze
• H51.11 — Convergence insufficiency
• H51.12 — Convergence excess
• H51.21 — Internuclear ophthalmoplegia, right eye
• H51.22 — Internuclear ophthalmoplegia, left eye
• H51.23 — Internuclear ophthalmoplegia, bilateral
• H51.8 — Other specified disorders of binocular movement

H53: Visual disturbances

• H53.121 — Transient visual loss, right eye
• H53.122 — Transient visual loss, left eye
• H53.123 — Transient visual loss, bilateral
• H53.131 — Sudden visual loss, right eye
• H53.132 — Sudden visual loss, left eye
• H53.133 — Sudden visual loss, bilateral
• H53.2 — Diplopia
• H53.411 — Scotoma involving central area, right eye
• H53.412 — Scotoma involving central area, left eye
• H53.413 — Scotoma involving central area, bilateral
• H53.461 — Homonymous bilateral field defects, right side
• H53.462 — Homonymous bilateral field defects, left side
• H53.47 — Heteronymous bilateral field defects
• H53.481 — Generalized contraction of visual field, right eye
• H53.482 — Generalized contraction of visual field, left eye
• H53.483 — Generalized contraction of visual field, bilateral

H54: Blindness and low vision

• H54.0X33 — Blindness right eye category 3, blindness left eye category 3
• H54.0X34 — Blindness right eye category 3, blindness left eye category 4
• H54.0X35 — Blindness right eye category 3, blindness left eye category 5
• H54.0X43 — Blindness right eye category 4, blindness left eye category 3
• H54.0X44 — Blindness right eye category 4, blindness left eye category 4
• H54.0X45 — Blindness right eye category 4, blindness left eye category 5
• H54.0X53 — Blindness right eye category 5, blindness left eye category 3
• H54.0X54 — Blindness right eye category 5, blindness left eye category 4
• H54.0X55 — Blindness right eye category 5, blindness left eye category 5
• H54.10 — Blindness, one eye, low vision other eye, unspecified eyes
• H54.1131 — Blindness right eye category 3, low vision left eye category 1
• H54.1132 — Blindness right eye category 3, low vision left eye category 2
• H54.1141 — Blindness right eye category 4, low vision left eye category 1
• H54.1142 — Blindness right eye category 4, low vision left eye category 2
• H54.1151 — Blindness right eye category 5, low vision left eye category 1
• H54.1152 — Blindness right eye category 5, low vision left eye category 2
• H54.1213 — Low vision right eye category 1, blindness left eye category 3
• H54.1214 — Low vision right eye category 1, blindness left eye category 4
• H54.1215 — Low vision right eye category 1, blindness left eye category 5
• H54.1223 — Low vision right eye category 2, blindness left eye category 3
• H54.1224 — Low vision right eye category 2, blindness left eye category 4
• H54.1225 — Low vision right eye category 2, blindness left eye category 5
• H54.2X11 — Low vision right eye category 1, low vision left eye category 1
• H54.2X12 — Low vision right eye category 1, low vision left eye category 2
• H54.2X21 — Low vision right eye category 2, low vision left eye category 1
• H54.2X22 — Low vision right eye category 2, low vision left eye category 2
• H54.413A — Blindness right eye category 3, normal vision left eye
• H54.414A — Blindness right eye category 4, normal vision left eye
• H54.415A — Blindness right eye category 5, normal vision left eye
• H54.42A3 — Blindness left eye category 3, normal vision right eye
• H54.42A4 — Blindness left eye category 4, normal vision right eye
• H54.42A5 — Blindness left eye category 5, normal vision right eye
• H54.511A — Low vision right eye category 1, normal vision left eye
• H54.512A — Low vision right eye category 2, normal vision left eye
• H54.52A1 — Low vision left eye category 1, normal vision right eye
• H54.52A2 — Low vision left eye category 2, normal vision right eye