Is H05.53 a billable ICD-10-CM code?

Yes. H05.53 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does H05.53 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).

What cannot be coded together with H05.53?

H05.53 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above H05.53 (H05.5, H05) and apply to it just the same.

H05.53

H05.53 — Retained (old) foreign body following penetrating wound of bilateral orbits

Billable / specific codeICD-10-CMbilateral

H05.53 is a billable, specific ICD-10-CM code for retained (old) foreign body following penetrating wound of bilateral orbits. It is valid for submission on a claim.

Excludes1 inherited from the categories above H05.53

These are not written on H05.53, but they bind it: a note on a category applies to every code beneath it. Billing H05.53 with anything listed here is a denial.

Written on H05.5 — Retained (old) foreign body following penetrating wound of orbit

current penetrating wound of orbit (S05.4-)

Written on H05 — Disorders of orbit

congenital malformation of orbit (Q10.7)

Excludes2 inherited from the categories above H05.53

Also inherited, and the opposite of Excludes1: these conditions are not part of H05.53, but a patient can have both, so you may code both.

Written on H05.5 — Retained (old) foreign body following penetrating wound of orbit

retained foreign body of eyelid (H02.81-)
retained intraocular foreign body (H44.6-, H44.7-)

Risk adjustment

H05.53 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

H05.53 is named in 13 Medicare coverage policies — 13 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

Code history

H05.53 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share H05.5. If H05.53 is not quite right, the correct code is usually one of these.

Questions about H05.53

Is H05.53 a billable ICD-10-CM code?: Yes. H05.53 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does H05.53 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).
What cannot be coded together with H05.53?: H05.53 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above H05.53 (H05.5, H05) and apply to it just the same.