2025 ICD-10-CM code H54.0X3
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the eye and adnexa - Visual disturbances and blindness Diseases of the eye and adnexa (H00-H59) Feed
Blindness in the right eye, category 3.
Modifiers may be applicable depending on the circumstances of the encounter and the services rendered. Consult the official coding guidelines for specific modifier usage.
Medical necessity for coding H54.0X3 is established by the presence of blindness in the right eye.The specific nature of the blindness and its underlying cause should be properly documented to ensure appropriate billing and reimbursement.
Ophthalmologists and other healthcare professionals involved in eye care are responsible for diagnosing and managing the condition.They should document the complete history, examination findings, and any treatment provided.
- Diseases of the eye and adnexa (H00-H59)
- H54.0X3 falls under the broader category of H54 (Blindness and low vision) and the even broader chapter of H00-H59 (Diseases of the eye and adnexa).
In simple words: This code means the person is blind in their right eye, and the 'category 3' provides more specific details about the type of blindness. A doctor needs more information to understand exactly why the person is blind in that eye.
This ICD-10-CM code, H54.0X3, specifies blindness in the right eye, categorized as level 3.The "X3" indicates a level of severity or specific characteristics of the blindness.Additional clinical details are required to accurately describe the nature and cause of the blindness.
Example 1: A patient presents with complete loss of vision in the right eye following a motor vehicle accident.The ophthalmologist documents complete blindness and confirms the diagnosis.Code H54.0X3 is used, along with an external cause code (from the injury chapter) to indicate the cause of blindness., A patient with long-standing diabetes develops severe diabetic retinopathy leading to blindness in the right eye.After a comprehensive ophthalmological examination and confirmation of the blindness, H54.0X3 would be used alongside a code for diabetic retinopathy (from the endocrine chapter)., A patient experiences sudden blindness in their right eye due to an ischemic event, such as a stroke. The ophthalmologist documents the blindness and after investigations, confirms the diagnosis. H54.0X3 would be used, and further codes would be used to indicate the underlying cerebrovascular event.
* Complete ophthalmologic examination notes including visual acuity testing, visual field testing, ophthalmoscopy findings and any other relevant diagnostic tests.* Detailed history of the patient's visual status and any relevant medical history.* Documentation of the underlying cause of the blindness, if identified (e.g., trauma, disease).* Description of any treatment provided.* Documentation to support the "category 3" classification which needs clarification from the original dataset.
** The 'X3' in H54.0X3 requires further specification within the original dataset to fully understand its clinical meaning and relevance for accurate billing.Additional clinical information is needed to completely understand the context of this code.
- Payment Status: Active
- Specialties:Ophthalmology
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Ambulatory Surgical Center