MCMedicalCodingSoftware
H57.04

H57.04: Mydriasis

Billable / specific codeICD-10-CM

H57.04 is a billable, specific ICD-10-CM code for mydriasis. It is valid for submission on a claim.

Check H57.04 with the rest of the claim: free scrubber

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

H57.04 is named in 6 Medicare coverage policies: 6 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

  • A56453Billing and Coding: Cataract Extraction
  • A56544Billing and Coding: Cataract Extraction
  • A56729Billing and Coding: Magnetic Resonance Imaging of the Head and Neck
  • A57204Billing and Coding: MRI and CT Scans of the Head and Neck

Alphabetic index entries that lead here

  • Mydriasis(pupil)
  • Dilatation›pupil
  • Anomaly, anomalous›pupil›function›mydriasis

Code history

Unchanged in every release from FY2024 to FY2027.

Other codes under H57.0

ICD-10-CMFY2027· effective October 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release: see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.