Version 2024

2024 ICD-10-CM Diagnosis Code H54.415A

Blindness right eye category 5, normal vision left eye

ICD-10-CM Code:: H54.415A
ICD-10 Code for:: Blindness right eye category 5, normal vision left eye
Is Billable?: Yes - Valid for Submission
Chronic Condition Indicator: ^[1]: Chronic
Code Navigator:

Code Information
Approximate Synonyms
Clinical Classification
Tabular List of Diseases and Injuries
Diagnostic Related Groups Mapping
Replacement Code
Convert to ICD-9 Code
Patient Education
Other Codes Used Similar Conditions
Code History

Code Classification

Diseases of the eye and adnexa
(H00–H59)
- Visual disturbances and blindness
  (H53-H54)
  - Blindness and low vision
    (H54)

H54.415A is a billable diagnosis code used to specify a medical diagnosis of blindness right eye category 5, normal vision left eye. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

Blind right eye
Blind right eye
Complete blindness of right eye
Complete pinhole blindness of right eye

Clinical Classification

Clinical Category is Blindness and vision defects
CCSR Category Code: EYE010
Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

H54.415A is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
124	OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT	02	1.3219
125	OTHER DISORDERS OF THE EYE WITHOUT MCC	02	0.7975

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Replacement Code

H54415A replaces the following previously assigned ICD-10-CM code(s):

H54.41 - Blindness, right eye, normal vision left eye

Convert H54.415A to ICD-9-CM

ICD-9-CM Code: 369.62 - One eye-tot/oth-near nor
Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.
ICD-9-CM Code: 369.63 - One eye-total/oth-normal
Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Other ICD-10-CM Codes Commonly Used for Similar Conditions

Filter related codes list:

H54 Blindness and low vision.
H54.0 Blindness, both eyes.
H54.0X Blindness, both eyes, different category levels.
H54.0X3 Blindness right eye, category 3.
H54.0X33 Blindness right eye category 3, blindness left eye category 3.
H54.0X34 Blindness right eye category 3, blindness left eye category 4.
H54.0X35 Blindness right eye category 3, blindness left eye category 5.
H54.0X4 Blindness right eye, category 4.
H54.0X43 Blindness right eye category 4, blindness left eye category 3.
H54.0X44 Blindness right eye category 4, blindness left eye category 4.
H54.0X45 Blindness right eye category 4, blindness left eye category 5.
H54.0X5 Blindness right eye, category 5.
H54.0X53 Blindness right eye category 5, blindness left eye category 3.
H54.0X54 Blindness right eye category 5, blindness left eye category 4.
H54.0X55 Blindness right eye category 5, blindness left eye category 5.
H54.1 Blindness, one eye, low vision other eye.
H54.10 Blindness, one eye, low vision other eye, unspecified eyes.
H54.11 Blindness, right eye, low vision left eye.
H54.113 Blindness right eye category 3, low vision left eye.
H54.1131 Blindness right eye category 3, low vision left eye category 1.
H54.1132 Blindness right eye category 3, low vision left eye category 2.
H54.114 Blindness right eye category 4, low vision left eye.
H54.1141 Blindness right eye category 4, low vision left eye category 1.
H54.1142 Blindness right eye category 4, low vision left eye category 2.
H54.115 Blindness right eye category 5, low vision left eye.
H54.1151 Blindness right eye category 5, low vision left eye category 1.
H54.1152 Blindness right eye category 5, low vision left eye category 2.
H54.12 Blindness, left eye, low vision right eye.
H54.121 Low vision right eye category 1, blindness left eye.
H54.1213 Low vision right eye category 1, blindness left eye category 3.
H54.1214 Low vision right eye category 1, blindness left eye category 4.
H54.1215 Low vision right eye category 1, blindness left eye category 5.
H54.122 Low vision right eye category 2, blindness left eye.
H54.1223 Low vision right eye category 2, blindness left eye category 3.
H54.1224 Low vision right eye category 2, blindness left eye category 4.
H54.1225 Low vision right eye category 2, blindness left eye category 5.
H54.2 Low vision, both eyes.
H54.2X Low vision, both eyes, different category levels.
H54.2X1 Low vision, right eye, category 1.
H54.2X11 Low vision right eye category 1, low vision left eye category 1.
H54.2X12 Low vision right eye category 1, low vision left eye category 2.
H54.2X2 Low vision, right eye, category 2.
H54.2X21 Low vision right eye category 2, low vision left eye category 1.
H54.2X22 Low vision right eye category 2, low vision left eye category 2.
H54.3 Unqualified visual loss, both eyes.
H54.4 Blindness, one eye.
H54.40 Blindness, one eye, unspecified eye.
H54.41 Blindness, right eye, normal vision left eye.
H54.413 Blindness, right eye, category 3.
H54.413A Blindness right eye category 3, normal vision left eye.
H54.414 Blindness, right eye, category 4.

Code History

FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
The condition places limitations on self-care, independent living, and social interactions.