2025 ICD-10-CM code H54.0X4
(Active) Effective Date: N/A Diseases of the eye and adnexa - Visual disturbances and blindness 7 Feed
Blindness, right eye, category 4.
Medical necessity for services related to the blindness diagnosis should be established. This includes the evaluation of the visual impairment and any associated medical conditions, along with any necessary treatment or assistive devices required for managing the vision loss.
Assessment and documentation of visual acuity and visual field in the right eye to determine if it meets the criteria for legal blindness, category 4. Further investigation and documentation of any underlying medical conditions contributing to the visual impairment are essential for proper coding. The ophthalmologist or optometrist is responsible for accurately classifying the level of vision loss.
In simple words: This code signifies legal blindness in your right eye, specifically categorized as level 4 visual impairment.This means your vision in that eye is severely limited, even with corrective lenses.
Blindness, right eye, category 4.This code indicates legal blindness in the right eye, with remaining vision falling into category 4 based on WHO criteria.It excludes transient vision loss (amaurosis fugax).Any underlying condition causing the blindness should be coded additionally.
Example 1: A patient with advanced glaucoma in the right eye has severely constricted visual fields and visual acuity that falls into the category 4 blindness criteria as per WHO guidelines. The left eye is unaffected., Following a traumatic injury to the right eye, a patient experiences significant vision loss qualifying as category 4 blindness. The left eye remains functional., A patient with macular degeneration in the right eye experiences progressive vision loss. Their current visual function is assessed to be at the level of legal blindness, category 4, while the left eye is less affected.
Documentation should include specific visual acuity measurements (e.g., Snellen chart) and visual field assessments for the right eye. Detailed clinical findings supporting the diagnosis of legal blindness, category 4, are crucial. Any associated diagnoses or medical conditions contributing to the vision loss should also be documented, along with relevant history and treatment plans.
** Category 4 blindness is defined according to World Health Organization (WHO) criteria. This code should be used in conjunction with other codes to fully describe the etiology and extent of the patient's visual impairment.
- Specialties:Ophthalmology, Optometry
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital