ICD-10 · PDGM grouping
H53-H54 — Visual disturbances and blindness
Every ICD-10-CM code in this range and the PDGM clinical group CMS assigns to it, read from the CMS grouper crosswalk v07.2.26.
ICD-10-CM FY2027 · CMS grouper v07.2.26
Codes in range
128
No clinical group
23
A period cannot be grouped from these.
Barred as primary
0
CMS rejects these in the primary position.
Where these codes group
105 of the 128 codes in H53-H54 group to MMTA - Other. A further 23 are assigned no clinical group at all, which means a 30-day period cannot be grouped from them.
Code families in H53-H54
One page per three-character family: every code in it, whether it can lead a claim, its clinical group and comorbidity subgroup.
Every code in H53-H54
Descriptions are CMS’s own, abbreviated as CMS abbreviates them.
| Code | Description | Clinical group | Primary position |
|---|---|---|---|
| H53001 | Unspecified amblyopia, right eye | A | Can lead a claim |
| H53002 | Unspecified amblyopia, left eye | A | Can lead a claim |
| H53003 | Unspecified amblyopia, bilateral | A | Can lead a claim |
| H53009 | Unspecified amblyopia, unspecified eye | None | Cannot lead a claim |
| H53011 | Deprivation amblyopia, right eye | A | Can lead a claim |
| H53012 | Deprivation amblyopia, left eye | A | Can lead a claim |
| H53013 | Deprivation amblyopia, bilateral | A | Can lead a claim |
| H53019 | Deprivation amblyopia, unspecified eye | None | Cannot lead a claim |
| H53021 | Refractive amblyopia, right eye | A | Can lead a claim |
| H53022 | Refractive amblyopia, left eye | A | Can lead a claim |
| H53023 | Refractive amblyopia, bilateral | A | Can lead a claim |
| H53029 | Refractive amblyopia, unspecified eye | None | Cannot lead a claim |
| H53031 | Strabismic amblyopia, right eye | A | Can lead a claim |
| H53032 | Strabismic amblyopia, left eye | A | Can lead a claim |
| H53033 | Strabismic amblyopia, bilateral | A | Can lead a claim |
| H53039 | Strabismic amblyopia, unspecified eye | None | Cannot lead a claim |
| H53041 | Amblyopia suspect, right eye | A | Can lead a claim |
| H53042 | Amblyopia suspect, left eye | A | Can lead a claim |
| H53043 | Amblyopia suspect, bilateral | A | Can lead a claim |
| H53049 | Amblyopia suspect, unspecified eye | None | Cannot lead a claim |
| H5310 | Unspecified subjective visual disturbances | None | Cannot lead a claim |
| H5311 | Day blindness | A | Can lead a claim |
| H53121 | Transient visual loss, right eye | A | Can lead a claim |
| H53122 | Transient visual loss, left eye | A | Can lead a claim |
| H53123 | Transient visual loss, bilateral | A | Can lead a claim |
| H53129 | Transient visual loss, unspecified eye | None | Cannot lead a claim |
| H53131 | Sudden visual loss, right eye | A | Can lead a claim |
| H53132 | Sudden visual loss, left eye | A | Can lead a claim |
| H53133 | Sudden visual loss, bilateral | A | Can lead a claim |
| H53139 | Sudden visual loss, unspecified eye | None | Cannot lead a claim |
| H53141 | Visual discomfort, right eye | A | Can lead a claim |
| H53142 | Visual discomfort, left eye | A | Can lead a claim |
| H53143 | Visual discomfort, bilateral | A | Can lead a claim |
| H53149 | Visual discomfort, unspecified | None | Cannot lead a claim |
| H5315 | Visual distortions of shape and size | A | Can lead a claim |
| H5316 | Psychophysical visual disturbances | A | Can lead a claim |
| H5319 | Other subjective visual disturbances | A | Can lead a claim |
| H532 | Diplopia | A | Can lead a claim |
| H5330 | Unspecified disorder of binocular vision | None | Cannot lead a claim |
| H5331 | Abnormal retinal correspondence | A | Can lead a claim |
| H5332 | Fusion with defective stereopsis | A | Can lead a claim |
| H5333 | Simultaneous visual perception without fusion | A | Can lead a claim |
| H5334 | Suppression of binocular vision | A | Can lead a claim |
| H5340 | Unspecified visual field defects | A | Can lead a claim |
| H53411 | Scotoma involving central area, right eye | A | Can lead a claim |
| H53412 | Scotoma involving central area, left eye | A | Can lead a claim |
| H53413 | Scotoma involving central area, bilateral | A | Can lead a claim |
| H53419 | Scotoma involving central area, unspecified eye | None | Cannot lead a claim |
| H53421 | Scotoma of blind spot area, right eye | A | Can lead a claim |
| H53422 | Scotoma of blind spot area, left eye | A | Can lead a claim |
| H53423 | Scotoma of blind spot area, bilateral | A | Can lead a claim |
| H53429 | Scotoma of blind spot area, unspecified eye | None | Cannot lead a claim |
| H53431 | Sector or arcuate defects, right eye | A | Can lead a claim |
| H53432 | Sector or arcuate defects, left eye | A | Can lead a claim |
| H53433 | Sector or arcuate defects, bilateral | A | Can lead a claim |
| H53439 | Sector or arcuate defects, unspecified eye | None | Cannot lead a claim |
| H53451 | Other localized visual field defect, right eye | A | Can lead a claim |
| H53452 | Other localized visual field defect, left eye | A | Can lead a claim |
| H53453 | Other localized visual field defect, bilateral | A | Can lead a claim |
| H53459 | Other localized visual field defect, unspecified eye | None | Cannot lead a claim |
| H53461 | Homonymous bilateral field defects, right side | A | Can lead a claim |
| H53462 | Homonymous bilateral field defects, left side | A | Can lead a claim |
| H53469 | Homonymous bilateral field defects, unspecified side | None | Cannot lead a claim |
| H5347 | Heteronymous bilateral field defects | A | Can lead a claim |
| H53481 | Generalized contraction of visual field, right eye | A | Can lead a claim |
| H53482 | Generalized contraction of visual field, left eye | A | Can lead a claim |
| H53483 | Generalized contraction of visual field, bilateral | A | Can lead a claim |
| H53489 | Generalized contraction of visual field, unspecified eye | None | Cannot lead a claim |
| H5350 | Unspecified color vision deficiencies | None | Cannot lead a claim |
| H5351 | Achromatopsia | A | Can lead a claim |
| H5352 | Acquired color vision deficiency | A | Can lead a claim |
| H5353 | Deuteranomaly | A | Can lead a claim |
| H5354 | Protanomaly | A | Can lead a claim |
| H5355 | Tritanomaly | A | Can lead a claim |
| H5359 | Other color vision deficiencies | A | Can lead a claim |
| H5360 | Unspecified night blindness | None | Cannot lead a claim |
| H5361 | Abnormal dark adaptation curve | A | Can lead a claim |
| H5362 | Acquired night blindness | A | Can lead a claim |
| H5363 | Congenital night blindness | A | Can lead a claim |
| H5369 | Other night blindness | A | Can lead a claim |
| H5371 | Glare sensitivity | A | Can lead a claim |
| H5372 | Impaired contrast sensitivity | A | Can lead a claim |
| H538 | Other visual disturbances | A | Can lead a claim |
| H539 | Unspecified visual disturbance | None | Cannot lead a claim |
| H540X33 | Blindness r eye category 3, blindness left eye category 3 | A | Can lead a claim, code first applies |
| H540X34 | Blindness r eye category 3, blindness left eye category 4 | A | Can lead a claim, code first applies |
| H540X35 | Blindness r eye category 3, blindness left eye category 5 | A | Can lead a claim, code first applies |
| H540X43 | Blindness r eye category 4, blindness left eye category 3 | A | Can lead a claim, code first applies |
| H540X44 | Blindness r eye category 4, blindness left eye category 4 | A | Can lead a claim, code first applies |
| H540X45 | Blindness r eye category 4, blindness left eye category 5 | A | Can lead a claim, code first applies |
| H540X53 | Blindness r eye category 5, blindness left eye category 3 | A | Can lead a claim, code first applies |
| H540X54 | Blindness r eye category 5, blindness left eye category 4 | A | Can lead a claim, code first applies |
| H540X55 | Blindness r eye category 5, blindness left eye category 5 | A | Can lead a claim, code first applies |
| H5410 | Blindness, one eye, low vision other eye, unspecified eyes | A | Can lead a claim, code first applies |
| H541131 | Blindness r eye category 3, low vision left eye category 1 | A | Can lead a claim, code first applies |
| H541132 | Blindness r eye category 3, low vision left eye category 2 | A | Can lead a claim, code first applies |
| H541141 | Blindness r eye category 4, low vision left eye category 1 | A | Can lead a claim, code first applies |
| H541142 | Blindness r eye category 4, low vision left eye category 2 | A | Can lead a claim, code first applies |
| H541151 | Blindness r eye category 5, low vision left eye category 1 | A | Can lead a claim, code first applies |
| H541152 | Blindness r eye category 5, low vision left eye category 2 | A | Can lead a claim, code first applies |
| H541213 | Low vision r eye category 1, blindness left eye category 3 | A | Can lead a claim, code first applies |
| H541214 | Low vision r eye category 1, blindness left eye category 4 | A | Can lead a claim, code first applies |
| H541215 | Low vision r eye category 1, blindness left eye category 5 | A | Can lead a claim, code first applies |
| H541223 | Low vision r eye category 2, blindness left eye category 3 | A | Can lead a claim, code first applies |
| H541224 | Low vision r eye category 2, blindness left eye category 4 | A | Can lead a claim, code first applies |
| H541225 | Low vision r eye category 2, blindness left eye category 5 | A | Can lead a claim, code first applies |
| H542X11 | Low vision r eye category 1, low vision left eye category 1 | A | Can lead a claim, code first applies |
| H542X12 | Low vision r eye category 1, low vision left eye category 2 | A | Can lead a claim, code first applies |
| H542X21 | Low vision r eye category 2, low vision left eye category 1 | A | Can lead a claim, code first applies |
| H542X22 | Low vision r eye category 2, low vision left eye category 2 | A | Can lead a claim, code first applies |
| H543 | Unqualified visual loss, both eyes | A | Can lead a claim, code first applies |
| H5440 | Blindness, one eye, unspecified eye | None | Cannot lead a claim |
| H54413A | Blindness right eye category 3, normal vision left eye | A | Can lead a claim, code first applies |
| H54414A | Blindness right eye category 4, normal vision left eye | A | Can lead a claim, code first applies |
| H54415A | Blindness right eye category 5, normal vision left eye | A | Can lead a claim, code first applies |
| H5442A3 | Blindness left eye category 3, normal vision right eye | A | Can lead a claim, code first applies |
| H5442A4 | Blindness left eye category 4, normal vision right eye | A | Can lead a claim, code first applies |
| H5442A5 | Blindness left eye category 5, normal vision right eye | A | Can lead a claim, code first applies |
| H5450 | Low vision, one eye, unspecified eye | None | Cannot lead a claim |
| H54511A | Low vision right eye category 1, normal vision left eye | A | Can lead a claim, code first applies |
| H54512A | Low vision right eye category 2, normal vision left eye | A | Can lead a claim, code first applies |
| H5452A1 | Low vision left eye category 1, normal vision right eye | A | Can lead a claim, code first applies |
| H5452A2 | Low vision left eye category 2, normal vision right eye | A | Can lead a claim, code first applies |
| H5460 | Unqualified visual loss, one eye, unspecified | None | Cannot lead a claim |
| H5461 | Unqualified visual loss, right eye, normal vision left eye | A | Can lead a claim, code first applies |
| H5462 | Unqualified visual loss, left eye, normal vision right eye | A | Can lead a claim, code first applies |
| H547 | Unspecified visual loss | None | Cannot lead a claim |
| H548 | Legal blindness, as defined in USA | A | Can lead a claim, code first applies |
Source: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01. 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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