H54 — Blindness and low vision
H54 is a non-billable header ICD-10-CM code for blindness and low vision. 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.
- amaurosis fugax (G45.3)
Code first
The underlying condition must be sequenced before this code.
- any associated underlying cause of the blindness
Notes
Additional guidance from the ICD-10-CM tabular list.
- For definition of visual impairment categories see table below
Other codes that can never be billed with H54
These codes carry an Excludes1 note pointing at H54. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading H54 alone.
- H54.8Legal blindness, as defined in USA
Risk adjustment
H54 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 H54
9 child codes. Green means billable.
Questions about H54
- Is H54 a billable ICD-10-CM code?
- No. H54 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does H54 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Visual disturbances and blindness (H53-H54).
- What cannot be coded together with H54?
- H54 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.