Other disorders of eye and adnexa
ICD-10 Codes (26)
H57H57.0H57.00H57.01H57.02H57.03H57.04H57.05H57.051H57.052H57.053H57.059H57.09H57.1H57.10H57.11H57.12H57.13H57.8H57.81H57.811H57.812H57.813H57.819H57.89H57.9Updates & Changes
FY 2026 Updates
Deleted Codes
No codes deleted in this range for FY 2026
No significant changes for FY 2026
This range maintains stability with current coding practices
Historical Changes
- •FY 2025: Routine maintenance updates with minor terminology clarifications
- •FY 2024: Enhanced specificity requirements for certain code ranges
- •FY 2023: Updated documentation guidelines for improved clarity
Upcoming Changes
- •Proposed updates pending review by Coordination and Maintenance Committee
- •Under consideration: Enhanced digital health integration codes
Implementation Guidance
- •Review all FY 2026 updates for H55-H57 codes before implementation
- •Always verify the most current codes in the ICD-10-CM manual
- •Ensure clinical documentation supports the selected diagnosis codes
- +3 more guidance items...
Range Overview
The ICD-10 code range H55-H57 refers to 'Other disorders of the eye and adnexa.' This range includes various conditions related to the eye and its associated structures, excluding those related to vision and blindness. It covers conditions such as nystagmus, other irregular eye movements, and disorders of the optic nerve and visual pathways.
Key Usage Points:
- •H55 codes are used for nystagmus and other irregular eye movements.
- •H56 codes cover various types of strabismus.
- •H57 codes are used for other disorders of the eye and adnexa, excluding those related to vision and blindness.
- •Always code to the highest level of specificity within this range.
- •Remember to code first any associated underlying disease.
Coding Guidelines
When to Use:
- ✓When a patient presents with nystagmus or other irregular eye movements.
- ✓When a patient has a diagnosis of strabismus.
- ✓When a patient has other disorders of the eye and adnexa, excluding those related to vision and blindness.
- ✓When a patient has complications related to these conditions.
- ✓When a patient has a history of these conditions.
When NOT to Use:
- ✗When the patient's condition is related to vision or blindness.
- ✗When the patient's condition is better represented by another code range.
- ✗When the patient's condition is not specifically diagnosed or confirmed.
- ✗When the patient's condition is transient or self-limiting.
- ✗When the patient's condition is not the focus of treatment.
Code Exclusions
Always verify the most appropriate code before finalizing the coding process.
Documentation Requirements
Documentation for this code range should clearly identify the specific condition, its severity, and any associated complications. The documentation should also include any underlying conditions and the patient's history of the condition.
Clinical Information:
- •Specific diagnosis
- •Severity of the condition
- •Associated complications
- •Underlying conditions
- •History of the condition
Supporting Evidence:
- •Clinical notes
- •Diagnostic test results
- •Imaging studies
- •Referral notes
Good Documentation Example:
Patient presents with severe nystagmus due to underlying multiple sclerosis. Diagnostic tests confirm the diagnosis.
Poor Documentation Example:
Patient has eye problems.
Common Documentation Errors:
- ⚠Not coding to the highest level of specificity
- ⚠Not documenting the underlying condition
- ⚠Not documenting the severity of the condition
- ⚠Not documenting associated complications
Range Statistics
Coding Complexity
The coding complexity for this range is medium due to the need to code to the highest level of specificity, code any associated underlying conditions, code any associated complications, differentiate between similar conditions, and stay current with changes to the code set.
Key Factors:
- ▸The need to code to the highest level of specificity
- ▸The need to code any associated underlying conditions
- ▸The need to code any associated complications
- ▸The need to differentiate between similar conditions
- ▸The need to stay current with changes to the code set
Specialty Focus
This code range is primarily used by ophthalmologists and optometrists. However, it may also be used by neurologists and primary care physicians when treating conditions related to the eye and adnexa.
Primary Specialties:
Clinical Scenarios:
- • A patient presents with nystagmus due to multiple sclerosis.
- • A child is diagnosed with strabismus.
- • A patient has an irregular eye movement due to a stroke.
- • A patient presents with a disorder of the eye related to diabetes.
- • A patient has a history of strabismus.
Resources & References
There are several resources available to help coders accurately use this code range. These include the official ICD-10 guidelines, clinical reference materials, and educational resources.
Official Guidelines:
- ICD-10-CM Official Guidelines for Coding and Reporting
- American Academy of Ophthalmology ICD-10 resources
- American Optometric Association ICD-10 resources
Clinical References:
- ClinicalKey
- UpToDate
Educational Materials:
- AAPC ICD-10 training
- AHIMA ICD-10 training
Frequently Asked Questions
What is the difference between H55 and H56 codes?
H55 codes are used for nystagmus and other irregular eye movements, while H56 codes are used for various types of strabismus.
When should I use H57 codes?
H57 codes are used for other disorders of the eye and adnexa, excluding those related to vision and blindness.