2025 ICD-10-CM code H54.0X
(Active) Effective Date: N/A Diseases of the eye and adnexa - Visual disturbances and blindness 7 Feed
Blindness in both eyes, with each eye having a different level of visual impairment.
This code requires additional characters to specify the category level for each eye.Modifiers are not typically used with ICD-10-CM codes.
Medical necessity for services related to this code stems from the need to manage the underlying condition causing blindness, provide supportive services (like vision rehabilitation), and assess the impact on the patient's overall health and functioning.
Assessment and documentation of visual acuity in both eyes, along with any underlying causes for the blindness. This typically includes a comprehensive eye exam by an ophthalmologist or optometrist.
In simple words: This code signifies a person is blind in both eyes, and the severity of blindness is different in each eye.
This code indicates blindness in both eyes, where each eye has a different category level of visual impairment.The categories range from 3 to 5, with 3 being the least severe and 5 being the most severe. Further documentation is needed to specify the specific category level for each eye by appending additional characters to the code (e.g., H54.0X33 for category 3 in both eyes, H54.0X34 for category 3 in the right eye and 4 in the left eye, etc.)
Example 1: A patient has complete blindness in the right eye (category 5) due to diabetic retinopathy and significantly reduced vision in the left eye (category 3) due to macular degeneration.The code H54.0X53 would be used., A patient is completely blind in their left eye (Category 5) due to trauma as a child and now has developed cataracts in their right eye resulting in near-total blindness (Category 4) The code H54.0X45 would be used., A patient experienced retinal detachments in both eyes. The right eye now has a visual impairment classified as Category 3, while the left eye is classified as Category 4. The appropriate code is H54.0X34.
Documentation should specify the underlying cause of blindness in each eye and the visual acuity category (3, 4, or 5) for each eye separately.This information should come from formal visual acuity testing.
** Visual impairment categories are defined as follows: Category 3: Moderate visual impairment; Category 4: Severe visual impairment; Category 5: Profound visual impairment or blindness. This information should be readily accessible in the patient's chart.
- Payment Status: Active
- Specialties:Ophthalmology, Optometry
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital