H21.563

H21.563: Pupillary abnormality, bilateral

Billable / specific codeICD-10-CMbilateral

H21.563 is a billable, specific ICD-10-CM code for pupillary abnormality, bilateral. It is valid for submission on a claim.

Check H21.563 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above H21.563

A category’s note binds every code beneath it.

Written on H21.56: Pupillary abnormalities

congenital deformity of pupil (Q13.2-)

Written on H21.5: Other and unspecified adhesions and disruptions of iris and ciliary body

corectopia (Q13.2)

Excludes2 inherited from the categories above H21.563

Not part of this code, but both may be coded when both are present.

Written on H21: Other disorders of iris and ciliary body

sympathetic uveitis (H44.1-)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

H21.563 is named in 13 Medicare coverage policies: 13 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
A56453Billing and Coding: Cataract Extraction
A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
A56544Billing and Coding: Cataract Extraction

Code history

Unchanged in every release from FY2024 to FY2027.