H53.423
H53.423 — Scotoma of blind spot area, bilateral
Billable / specific codeICD-10-CMbilateral
H53.423 is a billable, specific ICD-10-CM code for scotoma of blind spot area, bilateral. It is valid for submission on a claim.
Risk adjustment
H53.423 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
H53.423 is named in 22 Medicare coverage policies — 22 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
- A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
- A56551Billing and Coding: Visual Fields Testing
- A56612Billing and Coding: CT of the Head
Related codes at this level
Codes that share H53.42. If H53.423 is not quite right, the correct code is usually one of these.
Questions about H53.423
- Is H53.423 a billable ICD-10-CM code?
- Yes. H53.423 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H53.423 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Visual disturbances and blindness (H53-H54).