H49.31 — Total (external) ophthalmoplegia, right eye
H49.31 is a billable, specific ICD-10-CM code for total (external) ophthalmoplegia, right eye. It is valid for submission on a claim.
Excludes2 inherited from the categories above H49.31
Also inherited, and the opposite of Excludes1: these conditions are not part of H49.31, but a patient can have both, so you may code both.
Risk adjustment
H49.31 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
H49.31 is named in 31 Medicare coverage policies — 31 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A54095Billing and Coding: Nerve Conduction Studies and Electromyography
- A54095Billing and Coding: Nerve Conduction Studies and Electromyography
- A54969Billing and Coding: Nerve Conduction Studies and Electromyography
- A56551Billing and Coding: Visual Fields Testing
Code history
H49.31 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 H49.3. If H49.31 is not quite right, the correct code is usually one of these.
Questions about H49.31
- Is H49.31 a billable ICD-10-CM code?
- Yes. H49.31 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H49.31 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of ocular muscles, binocular movement, accommodation and refraction (H49-H52).