ICD-10 · PDGM grouping

H55-H57 — Other disorders of eye and adnexa

Every ICD-10-CM code in this range and the PDGM clinical group CMS assigns to it, read from the CMS grouper crosswalk v07.1.26.

OASIS-E2 v1.00.0 · ingested 2026-04-26

Codes in range

33

No clinical group

11

A period cannot be grouped from these.

Barred as primary

0

CMS rejects these in the primary position.

Where these codes group

22 of the 33 codes in H55-H57 group to MMTA - Other. A further 11 are assigned no clinical group at all, which means a 30-day period cannot be grouped from them.

Every code in H55-H57

Descriptions are CMS’s own, abbreviated as CMS abbreviates them.

CodeDescriptionClinical groupPrimary position
H5500Unspecified nystagmusAAccepted
H5501Congenital nystagmusAAccepted
H5502Latent nystagmusAAccepted
H5503Visual deprivation nystagmusAAccepted
H5504Dissociated nystagmusAAccepted
H5509Other forms of nystagmusAAccepted
H5581Deficient saccadic eye movementsAAccepted
H5582Deficient smooth pursuit eye movementsAAccepted
H5589Other irregular eye movementsAAccepted
H5700Unspecified anomaly of pupillary functionAAccepted
H5701Argyll Robertson pupil, atypicalAAccepted
H5702AnisocoriaAAccepted
H5703MiosisAAccepted
H5704MydriasisAAccepted
H57051Tonic pupil, right eyeAAccepted
H57052Tonic pupil, left eyeAAccepted
H57053Tonic pupil, bilateralAAccepted
H57059Tonic pupil, unspecified eyeNoneCannot group
H5709Other anomalies of pupillary functionAAccepted
H5710Ocular pain, unspecified eyeNoneCannot group
H5711Ocular pain, right eyeAAccepted
H5712Ocular pain, left eyeAAccepted
H5713Ocular pain, bilateralAAccepted
H57811Brow ptosis, rightNoneCannot group
H57812Brow ptosis, leftNoneCannot group
H57813Brow ptosis, bilateralNoneCannot group
H57819Brow ptosis, unspecifiedNoneCannot group
H5789Other specified disorders of eye and adnexaAAccepted
H578A1Foreign body sensation, right eyeNoneCannot group
H578A2Foreign body sensation, left eyeNoneCannot group
H578A3Foreign body sensation, bilateral eyesNoneCannot group
H578A9Foreign body sensation, unspecified eyeNoneCannot group
H579Unspecified disorder of eye and adnexaNoneCannot group

Source: CMS HH PPS Grouper Software v07.1.26, effective 2026-04-01. 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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