ICD-10 · PDGM grouping
H46 Optic neuritis
All 12 codes in the H46 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
12
Can lead a claim
8
Cannot lead a claim
4
What CMS assigns to H46
8 of the 12 codes group to MMTA - Other; 4 are assigned no clinical group. None of the 12 is assigned a comorbidity subgroup. 8 of the 12 can lead a claim. CMS attaches a code-first note to 1 of the 12.
Code first
CMS grouper convention 8, on H46.3. Code first:
- , if applicable, toxic effects of substances chiefly nonmedicinal as to source (T51-T65)
Every code in H46
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| H46.0 Optic papillitis | ||||
| H46.00 | Optic papillitis, unspecified eye | Cannot lead a claimUnspecified diagnosis code not acceptable as principal diagnosis since there is a more specific code available that would further accurately identify the condition | None | None |
| H46.01 | Optic papillitis, right eye | Can lead a claim | A | None |
| H46.02 | Optic papillitis, left eye | Can lead a claim | A | None |
| H46.03 | Optic papillitis, bilateral | Can lead a claim | A | None |
| H46.1 Retrobulbar neuritis | ||||
| H46.10 | Retrobulbar neuritis, unspecified eye | Cannot lead a claimUnspecified diagnosis code not acceptable as principal diagnosis since there is a more specific code available that would further accurately identify the condition | None | None |
| H46.11 | Retrobulbar neuritis, right eye | Can lead a claim | A | None |
| H46.12 | Retrobulbar neuritis, left eye | Can lead a claim | A | None |
| H46.13 | Retrobulbar neuritis, bilateral | Can lead a claim | A | None |
| H46.2 | Nutritional optic neuropathy | Can lead a claim | A | None |
| H46.3 | Toxic optic neuropathy | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H46.8 | Other optic neuritis | Can lead a claim | A | None |
| H46.9 | Unspecified optic neuritis | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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