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H49.11

H49.11: Fourth [trochlear] nerve palsy, right eye

Billable / specific codeICD-10-CMright

H49.11 is a billable, specific ICD-10-CM code for fourth [trochlear] nerve palsy, right eye. It is valid for submission on a claim.

Check H49.11 with the rest of the claim: free scrubber

Excludes2 inherited from the categories above H49.11

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

Written on H49: Paralytic strabismus

  • internal ophthalmoplegia (H52.51-)
  • internuclear ophthalmoplegia (H51.2-)
  • progressive supranuclear ophthalmoplegia (G23.1)

Risk adjustment

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

Medicare coverage

H49.11 is named in 30 Medicare coverage policies: 30 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

  • A54095Billing and Coding: Nerve Conduction Studies and Electromyography
  • A54969Billing and Coding: Nerve Conduction Studies and Electromyography
  • A56551Billing and Coding: Visual Fields Testing
  • A56612Billing and Coding: CT of the Head

Code history

Unchanged in every release from FY2024 to FY2027.

Other codes under H49.1

ICD-10-CMFY2027· effective October 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release: see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.