Is H54.8 a billable ICD-10-CM code?

Yes. H54.8 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does H54.8 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 H54.8?

H54.8 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

H54.8

H54.8 — Legal blindness, as defined in USA

Billable / specific codeICD-10-CM

H54.8 is a billable, specific ICD-10-CM code for legal blindness, as defined in usa. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

legal blindness with specification of impairment level (H54.0-H54.7)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Blindness NOS according to USA definition

Notes

Additional guidance from the ICD-10-CM tabular list.

The table below gives a classification of severity of visual impairment recommended by a WHO Study Group on the Prevention of Blindness, Geneva, 6-10 November 1972.
The term 'low vision' in category H54 comprises categories 1 and 2 of the table, the term 'blindness' categories 3, 4 and 5, and the term 'unqualified visual loss' category 9.
If the extent of the visual field is taken into account, patients with a field no greater than 10 but greater than 5 around central fixation should be placed in category 3 and patients with a field no greater than 5 around central fixation should be placed in category 4, even if the central acuity is not impaired.

Risk adjustment

H54.8 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

H54.8 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 H54.8 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 H54.8.

Blindness›legal(both eyes) (USA definition)

Related codes at this level

Codes that share H54. If H54.8 is not quite right, the correct code is usually one of these.

Questions about H54.8

Is H54.8 a billable ICD-10-CM code?: Yes. H54.8 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does H54.8 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 H54.8?: H54.8 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.