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v1.0.0
ICD-10 Guide
DiagnosesAstigmatism Bilateral

Astigmatism Bilateral

ICD-10 Coding for Bilateral Astigmatism(H52.223, H52.213, H52.203)

PRIMARY SPECIALTYOptometry
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Astigmatism Bilateral?
Essential facts and insights about Bilateral Astigmatism

Key Clinical Considerations:

  • Blurred or distorted vision
  • Difficulty seeing at night
  • Frequent squinting or eye strain

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history and symptoms
  • Results from visual acuity tests
  • Corneal topography or keratometry results

Coding Guidelines

Usage Guidelines & Examples

  • Use H52.13 for bilateral astigmatism; avoid using codes for other refractive errors.
  • Common errors include misclassifying astigmatism as myopia or hyperopia.

Code Exclusions

Important Exclusions

  • Excludes keratoconus and other corneal irregularities
  • Alternative codes for unilateral astigmatism (H52.12)

Related ICD-10 Codes

Primary Codes
H52.13
Astigmatism, bilateral
Ancillary Codes
Z01.00
T85.89XA
Differential Codes
H52.213
H52.223

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Optometry

Specialty Applications

  • Adults and children with refractive errors
  • Optometry clinics and ophthalmology practices

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

Documentation requirements?

Include visual acuity measurements and corneal curvature data.

Billing considerations?

Ensure proper coding to reflect the severity and type of astigmatism.