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ICD-10-CM Codes
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H00-H59
Diseases of the eye and adnexa
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H49-H52
Disorders of ocular muscles, binocular movement, accommodation and refraction
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H49-
Paralytic strabismus
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2021 ICD-10-CM Diagnosis Code H49.4
2021 ICD-10-CM Diagnosis Code H49.4
Progressive external ophthalmoplegia
2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code
- H49.4 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
- The 2021 edition of ICD-10-CM H49.4 became effective on October 1, 2020.
- This is the American ICD-10-CM version of H49.4 - other international versions of ICD-10 H49.4 may differ.
Type 1 ExcludesType 1 Excludes Help
A type 1 excludes note is a pure excludes. It means "not coded here". A type 1 excludes note indicates that the code excluded should never be used at the same time as H49.4. A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
The following code(s) above
H49.4 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
- Applicable To annotations, or
- Code Also annotations, or
- Code First annotations, or
- Excludes1 annotations, or
- Excludes2 annotations, or
- Includes annotations, or
- Note annotations, or
- Use Additional annotations
that may be applicable to
H49.4:
- H00-H59
2021 ICD-10-CM Range H00-H59
Diseases of the eye and adnexaNote- Use an external cause code following the code for the eye condition, if applicable, to identify the cause of the eye condition
Type 2 Excludes- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury (trauma) of eye and orbit (S05.-)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
- syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)
Diseases of the eye and adnexa - H49-H52
2021 ICD-10-CM Range H49-H52
Disorders of ocular muscles, binocular movement, accommodation and refractionType 2 Excludes- nystagmus and other irregular eye movements (H55)
Disorders of ocular muscles, binocular movement, accommodation and refraction - H49
ICD-10-CM Diagnosis Code H49
Paralytic strabismus
2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code
Type 2 Excludes- internal ophthalmoplegia (H52.51-)
- internuclear ophthalmoplegia (H51.2-)
- progressive supranuclear ophthalmoplegia (G23.1)
Paralytic strabismus
Clinical Information
- A disorder characterized by slowly progressive paralysis of the external eye muscles
- A mitochondrial myopathy characterized by slowly progressive paralysis of the levator palpebrae, orbicularis oculi, and extraocular muscles. Ragged-red fibers and atrophy are found on muscle biopsy. Familial and sporadic forms may occur. Disease onset is usually in the first or second decade of life, and the illness slowly progresses until usually all ocular motility is lost. (from Adams et al., Principles of Neurology, 6th ed, p1422)
Code History
- 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
- 2017 (effective 10/1/2016): No change
- 2018 (effective 10/1/2017): No change
- 2019 (effective 10/1/2018): No change
- 2020 (effective 10/1/2019): No change
- 2021 (effective 10/1/2020): No change
- Ophthalmoplegia - see also Strabismus, paralytic
- external H49.88-
ICD-10-CM Diagnosis Code H49.88-
Other paralytic strabismus
2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code
Applicable To- External ophthalmoplegia NOS
- Strabismus (congenital) (nonparalytic) H50.9
ICD-10-CM Diagnosis Code H50.9
Unspecified strabismus
2016 2017 2018 2019 2020 2021 Billable/Specific Code
- paralytic H49.9
ICD-10-CM Diagnosis Code H49.9
Unspecified paralytic strabismus
2016 2017 2018 2019 2020 2021 Billable/Specific Code
ICD-10-CM Codes Adjacent To H49.4
H49.2 Sixth [abducent] nerve palsy
H49.3 Total (external) ophthalmoplegia
H49.4
Progressive external ophthalmoplegia
H49.8 Other paralytic strabismus
Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.