H05.423
H05.423 — Enophthalmos due to trauma or surgery, bilateral
Billable / specific codeICD-10-CMbilateral
H05.423 is a billable, specific ICD-10-CM code for enophthalmos due to trauma or surgery, bilateral. It is valid for submission on a claim.
Risk adjustment
H05.423 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
H05.423 is named in 12 Medicare coverage policies — 12 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
- A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
- A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
- A56551Billing and Coding: Visual Fields Testing
Related codes at this level
Codes that share H05.42. If H05.423 is not quite right, the correct code is usually one of these.
Questions about H05.423
- Is H05.423 a billable ICD-10-CM code?
- Yes. H05.423 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H05.423 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of eyelid, lacrimal system and orbit (H00-H05).