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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-)

Excludes2 inherited from the categories above H49.4

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.

Code history

Unchanged in every release from FY2024 to FY2027.

Code to one of these instead H49.4

4 child codes. Green means billable.

Other codes under H49

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.