Is H54.0X35 a billable ICD-10-CM code?

Yes. H54.0X35 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does H54.0X35 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 H54.0X35?

H54.0X35 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above H54.0X35 (H54) and apply to it just the same.

H54.0X35

H54.0X35 — Blindness right eye category 3, blindness left eye category 5

Billable / specific codeICD-10-CMright

H54.0X35 is a billable, specific ICD-10-CM code for blindness right eye category 3, blindness left eye category 5. It is valid for submission on a claim.

Excludes1 inherited from the categories above H54.0X35

These are not written on H54.0X35, but they bind it: a note on a category applies to every code beneath it. Billing H54.0X35 with anything listed here is a denial.

Written on H54 — Blindness and low vision

amaurosis fugax (G45.3)

Risk adjustment

H54.0X35 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

H54.0X35 is named in 13 Medicare coverage policies — 13 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A53057Billing and Coding: Home Health Occupational Therapy
A53064Billing and Coding: Outpatient Occupational Therapy
A56551Billing and Coding: Visual Fields Testing
A56672Billing and Coding: Electroretinography (ERG)

Code history

H54.0X35 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share H54.0X3. If H54.0X35 is not quite right, the correct code is usually one of these.

Questions about H54.0X35

Is H54.0X35 a billable ICD-10-CM code?: Yes. H54.0X35 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does H54.0X35 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 H54.0X35?: H54.0X35 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above H54.0X35 (H54) and apply to it just the same.