ICD-10 · PDGM grouping
H54 Blindness and low vision
All 44 codes in the H54 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.
ICD-10-CM FY2027 · CMS grouper v07.2.26
Codes in family
44
Can lead a claim
40
Cannot lead a claim
4
What CMS assigns to H54
40 of the 44 codes group to MMTA - Other; 4 are assigned no clinical group. 38 of the 44 count toward the Disease of the Macula and Blindness/Low Vision comorbidity subgroup; 6 are assigned none. 40 of the 44 can lead a claim. CMS attaches a code-first note to all 44.
- Disease of the Macula and Blindness/Low Vision
Code first
CMS grouper convention 12, on all 44 codes. Code first:
- underlying disease
Every code in H54
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 |
|---|---|---|---|---|
| H54.0 Blindness, both eyes | ||||
| H54.0X Blindness, both eyes, different category levels | ||||
| H54.0X3 Blindness right eye, category 3 | ||||
| H54.0X33 | Blindness right eye category 3, blindness left eye category 3CMS: Blindness r eye category 3, blindness left eye category 3 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.0X34 | Blindness right eye category 3, blindness left eye category 4CMS: Blindness r eye category 3, blindness left eye category 4 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.0X35 | Blindness right eye category 3, blindness left eye category 5CMS: Blindness r eye category 3, blindness left eye category 5 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.0X4 Blindness right eye, category 4 | ||||
| H54.0X43 | Blindness right eye category 4, blindness left eye category 3CMS: Blindness r eye category 4, blindness left eye category 3 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.0X44 | Blindness right eye category 4, blindness left eye category 4CMS: Blindness r eye category 4, blindness left eye category 4 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.0X45 | Blindness right eye category 4, blindness left eye category 5CMS: Blindness r eye category 4, blindness left eye category 5 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.0X5 Blindness right eye, category 5 | ||||
| H54.0X53 | Blindness right eye category 5, blindness left eye category 3CMS: Blindness r eye category 5, blindness left eye category 3 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.0X54 | Blindness right eye category 5, blindness left eye category 4CMS: Blindness r eye category 5, blindness left eye category 4 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.0X55 | Blindness right eye category 5, blindness left eye category 5CMS: Blindness r eye category 5, blindness left eye category 5 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.1 Blindness, one eye, low vision other eye | ||||
| H54.10 | Blindness, one eye, low vision other eye, unspecified eyes | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.11 Blindness, right eye, low vision left eye | ||||
| H54.113 Blindness right eye category 3, low vision left eye | ||||
| H54.1131 | Blindness right eye category 3, low vision left eye category 1CMS: Blindness r eye category 3, low vision left eye category 1 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.1132 | Blindness right eye category 3, low vision left eye category 2CMS: Blindness r eye category 3, low vision left eye category 2 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.114 Blindness right eye category 4, low vision left eye | ||||
| H54.1141 | Blindness right eye category 4, low vision left eye category 1CMS: Blindness r eye category 4, low vision left eye category 1 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.1142 | Blindness right eye category 4, low vision left eye category 2CMS: Blindness r eye category 4, low vision left eye category 2 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.115 Blindness right eye category 5, low vision left eye | ||||
| H54.1151 | Blindness right eye category 5, low vision left eye category 1CMS: Blindness r eye category 5, low vision left eye category 1 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.1152 | Blindness right eye category 5, low vision left eye category 2CMS: Blindness r eye category 5, low vision left eye category 2 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.12 Blindness, left eye, low vision right eye | ||||
| H54.121 Low vision right eye category 1, blindness left eye | ||||
| H54.1213 | Low vision right eye category 1, blindness left eye category 3CMS: Low vision r eye category 1, blindness left eye category 3 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.1214 | Low vision right eye category 1, blindness left eye category 4CMS: Low vision r eye category 1, blindness left eye category 4 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.1215 | Low vision right eye category 1, blindness left eye category 5CMS: Low vision r eye category 1, blindness left eye category 5 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.122 Low vision right eye category 2, blindness left eye | ||||
| H54.1223 | Low vision right eye category 2, blindness left eye category 3CMS: Low vision r eye category 2, blindness left eye category 3 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.1224 | Low vision right eye category 2, blindness left eye category 4CMS: Low vision r eye category 2, blindness left eye category 4 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.1225 | Low vision right eye category 2, blindness left eye category 5CMS: Low vision r eye category 2, blindness left eye category 5 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.2 Low vision, both eyes | ||||
| H54.2X Low vision, both eyes, different category levels | ||||
| H54.2X1 Low vision, right eye, category 1 | ||||
| H54.2X11 | Low vision right eye category 1, low vision left eye category 1CMS: Low vision r eye category 1, low vision left eye category 1 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.2X12 | Low vision right eye category 1, low vision left eye category 2CMS: Low vision r eye category 1, low vision left eye category 2 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.2X2 Low vision, right eye, category 2 | ||||
| H54.2X21 | Low vision right eye category 2, low vision left eye category 1CMS: Low vision r eye category 2, low vision left eye category 1 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.2X22 | Low vision right eye category 2, low vision left eye category 2CMS: Low vision r eye category 2, low vision left eye category 2 | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.3 | Unqualified visual loss, both eyes | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.4 Blindness, one eye | ||||
| H54.40 | Blindness, one eye, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H54.41 Blindness, right eye, normal vision left eye | ||||
| H54.413 Blindness, right eye, category 3 | ||||
| H54.413A | Blindness right eye category 3, normal vision left eye | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.414 Blindness, right eye, category 4 | ||||
| H54.414A | Blindness right eye category 4, normal vision left eye | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.415 Blindness, right eye, category 5 | ||||
| H54.415A | Blindness right eye category 5, normal vision left eye | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.42 Blindness, left eye, normal vision right eye | ||||
| H54.42A Blindness, left eye, category 3-5 | ||||
| H54.42A3 | Blindness left eye category 3, normal vision right eye | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.42A4 | Blindness left eye category 4, normal vision right eye | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.42A5 | Blindness left eye category 5, normal vision right eye | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.5 Low vision, one eye | ||||
| H54.50 | Low vision, one eye, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H54.51 Low vision, right eye, normal vision left eye | ||||
| H54.511 Low vision, right eye, category 1 | ||||
| H54.511A | Low vision right eye category 1, normal vision left eye | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.512 Low vision, right eye, category 2 | ||||
| H54.512A | Low vision right eye category 2, normal vision left eye | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.52 Low vision, left eye, normal vision right eye | ||||
| H54.52A Low vision, left eye, category 1-2 | ||||
| H54.52A1 | Low vision left eye category 1, normal vision right eye | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.52A2 | Low vision left eye category 2, normal vision right eye | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
| H54.6 Unqualified visual loss, one eye | ||||
| H54.60 | Unqualified visual loss, one eye, unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H54.61 | Unqualified visual loss, right eye, normal vision left eye | Can lead a claim, code first applies | A | None |
| H54.62 | Unqualified visual loss, left eye, normal vision right eye | Can lead a claim, code first applies | A | None |
| H54.7 | Unspecified visual loss | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H54.8 | Legal blindness, as defined in USA | Can lead a claim, code first applies | A | Disease of the Macula and Blindness/Low Vision |
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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