H57.053
H57.053 — Tonic pupil, bilateral
Billable / specific codeICD-10-CMbilateral
H57.053 is a billable, specific ICD-10-CM code for tonic pupil, bilateral. It is valid for submission on a claim.
Risk adjustment
H57.053 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
H57.053 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
Related codes at this level
Codes that share H57.05. If H57.053 is not quite right, the correct code is usually one of these.
Questions about H57.053
- Is H57.053 a billable ICD-10-CM code?
- Yes. H57.053 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H57.053 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Other disorders of eye and adnexa (H55-H57).