H57.052
H57.052 — Tonic pupil, left eye
Billable / specific codeICD-10-CMleft
H57.052 is a billable, specific ICD-10-CM code for tonic pupil, left eye. It is valid for submission on a claim.
Risk adjustment
H57.052 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
H57.052 is named in 6 Medicare coverage policies — 6 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- 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
Code history
H57.052 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 H57.05. If H57.052 is not quite right, the correct code is usually one of these.
Questions about H57.052
- Is H57.052 a billable ICD-10-CM code?
- Yes. H57.052 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H57.052 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Other disorders of eye and adnexa (H55-H57).