Is H46.12 a billable ICD-10-CM code?

Yes. H46.12 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does H46.12 sit in the tabular list?

Diseases of the eye and adnexa (H00-H59), in the block Disorders of optic nerve and visual pathways (H46-H47).

What cannot be coded together with H46.12?

H46.12 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 H46.12 (H46.1) and apply to it just the same.

H46.12

H46.12 — Retrobulbar neuritis, left eye

Billable / specific codeICD-10-CMleft

H46.12 is a billable, specific ICD-10-CM code for retrobulbar neuritis, left eye. It is valid for submission on a claim.

Excludes1 inherited from the categories above H46.12

These are not written on H46.12, but they bind it: a note on a category applies to every code beneath it. Billing H46.12 with anything listed here is a denial.

Written on H46.1 — Retrobulbar neuritis

syphilitic retrobulbar neuritis (A52.15)

Excludes2 inherited from the categories above H46.12

Also inherited, and the opposite of Excludes1: these conditions are not part of H46.12, but a patient can have both, so you may code both.

Written on H46 — Optic neuritis

ischemic optic neuropathy (H47.01-)
neuromyelitis optica [Devic] (G36.0)

Risk adjustment

H46.12 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

H46.12 is named in 26 Medicare coverage policies — 26 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
A56551Billing and Coding: Visual Fields Testing
A56612Billing and Coding: CT of the Head
A56672Billing and Coding: Electroretinography (ERG)

Code history

H46.12 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 H46.1. If H46.12 is not quite right, the correct code is usually one of these.

Questions about H46.12

Is H46.12 a billable ICD-10-CM code?: Yes. H46.12 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does H46.12 sit in the tabular list?: Diseases of the eye and adnexa (H00-H59), in the block Disorders of optic nerve and visual pathways (H46-H47).
What cannot be coded together with H46.12?: H46.12 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 H46.12 (H46.1) and apply to it just the same.