Is H49.4 a billable ICD-10-CM code?

No. H49.4 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does H49.4 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).

What cannot be coded together with H49.4?

H49.4 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

H49.4

H49.4 — Progressive external ophthalmoplegia

Non-billable headerICD-10-CM

H49.4 is a non-billable header ICD-10-CM code for progressive external ophthalmoplegia. 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.

Kearns-Sayre syndrome (H49.81-)

Risk adjustment

H49.4 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.

Code to one of these instead H49.4

4 child codes. Green means billable.

Related codes at this level

Codes that share H49. If H49.4 is not quite right, the correct code is usually one of these.

Questions about H49.4

Is H49.4 a billable ICD-10-CM code?: No. H49.4 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does H49.4 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).
What cannot be coded together with H49.4?: H49.4 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.