H54.3 — Unqualified visual loss, both eyes
H54.3 is a billable, specific ICD-10-CM code for unqualified visual loss, both eyes. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Visual impairment category 9 in both eyes.
Risk adjustment
H54.3 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
H54.3 is named in 8 Medicare coverage policies — 8 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56551Billing and Coding: Visual Fields Testing
- A56799Billing and Coding: Visual Fields Testing
- A57060Billing and Coding: Visual Electrophysiology Testing
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
How H54.3 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 H54.3.
- Impaired, impairment›vision NEC›both eyes
- Loss›vision, visual›both eyes
Related codes at this level
Codes that share H54. If H54.3 is not quite right, the correct code is usually one of these.
Questions about H54.3
- Is H54.3 a billable ICD-10-CM code?
- Yes. H54.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H54.3 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Visual disturbances and blindness (H53-H54).