H21.56
H21.56: Pupillary abnormalities
Non-billable headerICD-10-CM
H21.56 is a non-billable header ICD-10-CM code for pupillary abnormalities. It cannot be billed on its own: choose one of the more specific child codes below.
Excludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- congenital deformity of pupil (Q13.2-)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Deformed pupil
- Ectopic pupil
- Rupture of sphincter, pupil
Excludes1 inherited from the categories above H21.56
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above H21.56
Not part of this code, but both may be coded when both are present.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Code history
Unchanged in every release from FY2024 to FY2027.
Code to one of these instead H21.56
4 child codes. Green means billable.