ICD-10 · PDGM grouping
H57 Other disorders of eye and adnexa
All 24 codes in the H57 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
24
Can lead a claim
13
Cannot lead a claim
11
What CMS assigns to H57
13 of the 24 codes group to MMTA - Other; 11 are assigned no clinical group. None of the 24 is assigned a comorbidity subgroup. 13 of the 24 can lead a claim.
Every code in H57
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 |
|---|---|---|---|---|
| H57.0 Anomalies of pupillary function | ||||
| H57.00 | Unspecified anomaly of pupillary function | Can lead a claim | A | None |
| H57.01 | Argyll Robertson pupil, atypical | Can lead a claim | A | None |
| H57.02 | Anisocoria | Can lead a claim | A | None |
| H57.03 | Miosis | Can lead a claim | A | None |
| H57.04 | Mydriasis | Can lead a claim | A | None |
| H57.05 Tonic pupil | ||||
| H57.051 | Tonic pupil, right eye | Can lead a claim | A | None |
| H57.052 | Tonic pupil, left eye | Can lead a claim | A | None |
| H57.053 | Tonic pupil, bilateral | Can lead a claim | A | None |
| H57.059 | Tonic pupil, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H57.09 | Other anomalies of pupillary function | Can lead a claim | A | None |
| H57.1 Ocular pain | ||||
| H57.10 | Ocular pain, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H57.11 | Ocular pain, right eye | Can lead a claim | A | None |
| H57.12 | Ocular pain, left eye | Can lead a claim | A | None |
| H57.13 | Ocular pain, bilateral | Can lead a claim | A | None |
| H57.8 Other specified disorders of eye and adnexa | ||||
| H57.81 Brow ptosis | ||||
| H57.811 | Brow ptosis, right | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H57.812 | Brow ptosis, left | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H57.813 | Brow ptosis, bilateral | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H57.819 | Brow ptosis, unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H57.89 | Other specified disorders of eye and adnexa | Can lead a claim | A | None |
| H57.8A Foreign body sensation eye (ocular) | ||||
| H57.8A1 | Foreign body sensation, right eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H57.8A2 | Foreign body sensation, left eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H57.8A3 | Foreign body sensation, bilateral eyes | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H57.8A9 | Foreign body sensation, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H57.9 | Unspecified disorder of eye and adnexa | 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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