H53.54 — Protanomaly
H53.54 is a billable, specific ICD-10-CM code for protanomaly. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Protanopia
Risk adjustment
H53.54 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
H53.54 is named in 7 Medicare coverage policies — 7 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
- A56726Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
- A56773Billing and Coding: Neurophysiology Evoked Potentials (NEPs)
- A57071Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
How H53.54 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to H53.54.
- Protanomaly(anomalous trichromat)
- Protanopia(complete) (incomplete)
- Deficiency, deficient›color vision›protanomaly
Related codes at this level
Codes that share H53.5. If H53.54 is not quite right, the correct code is usually one of these.
Questions about H53.54
- Is H53.54 a billable ICD-10-CM code?
- Yes. H53.54 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H53.54 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Visual disturbances and blindness (H53-H54).