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 v07.2.26.
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.
Code families in H55-H57
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 H55-H57
Descriptions are CMS’s own, abbreviated as CMS abbreviates them.
| Code | Description | Clinical group | Primary position |
|---|---|---|---|
| H5500 | Unspecified nystagmus | A | Can lead a claim |
| H5501 | Congenital nystagmus | A | Can lead a claim |
| H5502 | Latent nystagmus | A | Can lead a claim |
| H5503 | Visual deprivation nystagmus | A | Can lead a claim |
| H5504 | Dissociated nystagmus | A | Can lead a claim |
| H5509 | Other forms of nystagmus | A | Can lead a claim |
| H5581 | Deficient saccadic eye movements | A | Can lead a claim |
| H5582 | Deficient smooth pursuit eye movements | A | Can lead a claim |
| H5589 | Other irregular eye movements | A | Can lead a claim |
| H5700 | Unspecified anomaly of pupillary function | A | Can lead a claim |
| H5701 | Argyll Robertson pupil, atypical | A | Can lead a claim |
| H5702 | Anisocoria | A | Can lead a claim |
| H5703 | Miosis | A | Can lead a claim |
| H5704 | Mydriasis | A | Can lead a claim |
| H57051 | Tonic pupil, right eye | A | Can lead a claim |
| H57052 | Tonic pupil, left eye | A | Can lead a claim |
| H57053 | Tonic pupil, bilateral | A | Can lead a claim |
| H57059 | Tonic pupil, unspecified eye | None | Cannot lead a claim |
| H5709 | Other anomalies of pupillary function | A | Can lead a claim |
| H5710 | Ocular pain, unspecified eye | None | Cannot lead a claim |
| H5711 | Ocular pain, right eye | A | Can lead a claim |
| H5712 | Ocular pain, left eye | A | Can lead a claim |
| H5713 | Ocular pain, bilateral | A | Can lead a claim |
| H57811 | Brow ptosis, right | None | Cannot lead a claim |
| H57812 | Brow ptosis, left | None | Cannot lead a claim |
| H57813 | Brow ptosis, bilateral | None | Cannot lead a claim |
| H57819 | Brow ptosis, unspecified | None | Cannot lead a claim |
| H5789 | Other specified disorders of eye and adnexa | A | Can lead a claim |
| H578A1 | Foreign body sensation, right eye | None | Cannot lead a claim |
| H578A2 | Foreign body sensation, left eye | None | Cannot lead a claim |
| H578A3 | Foreign body sensation, bilateral eyes | None | Cannot lead a claim |
| H578A9 | Foreign body sensation, unspecified eye | None | Cannot lead a claim |
| H579 | Unspecified disorder of eye and adnexa | None | Cannot lead a claim |
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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