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.
Check H54.8 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
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
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
H54.8 is named in 8 Medicare coverage policies: 8 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- 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
Alphabetic index entries that lead here
- Blindness›legal(both eyes) (USA definition)
Code history
Unchanged in every release from FY2024 to FY2027.