H57.059
H57.059 — Tonic pupil, unspecified eye
Billable / specific codeICD-10-CMunspecified
H57.059 is a billable, specific ICD-10-CM code for tonic pupil, unspecified eye. It is valid for submission on a claim.
Risk adjustment
H57.059 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
H57.059 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
Related codes at this level
Codes that share H57.05. If H57.059 is not quite right, the correct code is usually one of these.
Questions about H57.059
- Is H57.059 a billable ICD-10-CM code?
- Yes. H57.059 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H57.059 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Other disorders of eye and adnexa (H55-H57).