2027 ICD-10-CM Diagnosis Code H46.3Toxic optic neuropathy

ICD-10-CM Codes›H00–H59›H46-H47›H46

ICD-10-CM H46.3
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

H46.3 is a billable ICD-10-CM diagnosis code for toxic optic neuropathy. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 123. Coders also document this condition as drug induced optic neuropathy. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Drug induced or toxic related condition and Neuro-ophthalmology.

Code Identity

ICD-10-CM Code
H46.3
Billable Status
Yes — Valid for Submission
Code Describes
Toxic optic neuropathy
Short Description
Toxic optic neuropathy
Same as the full description in the CMS dataset.
Parent Code
H46
Optic neuritis

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH46-H47Disorders of optic nerve and visual pathways
CategoryH46Optic neuritis
This CodeH46.3Toxic optic neuropathy

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Drug induced optic neuropathy
  • Optic neuropathy caused by alcohol
  • Tobacco related optic neuropathy
  • Toxic optic neuropathy

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to H46.3: its own notes plus those printed at H46 and Chapter 7. A note printed at a category, block or chapter applies to every code under it.

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From H46 Optic neuritis applies to 12 codes
  • ischemic optic neuropathy (H47.01-)
  • neuromyelitis optica [Devic] (G36.0)
From Chapter 7 (H00-H59) Diseases of the eye and adnexa applies to 2,677 codes
  • 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)

Code First

The underlying condition named in the note is sequenced before this code.

Notes

General instructions on how these codes are used.

From Chapter 7 (H00-H59) Diseases of the eye and adnexa applies to 2,677 codes
  • Use an external cause code following the code for the eye condition, if applicable, to identify the cause of the eye condition

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name H46.3, its category, or a range that includes it.

Excludes2 2

These codes carry an Excludes2 note naming H46.3: its condition is not part of those codes, and both may be reported when the patient has both.

  • G36.0 Neuromyelitis optica [Devic]
    optic neuritis NOS (H46) names H46, which includes this code
  • G52 Disorders of other cranial nerves
    disorders of optic [2nd] nerve (H46, H47.0) names H46, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INJ030
Drug induced or toxic related condition
Default principal diagnosis: inpatient No · outpatient No
CCSR EYE006
Neuro-ophthalmology
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Toxic Optic Neuropathy

    damage to the eye or its function (e.g., visual impairment) due to optic nerve damage secondary to toxic substances such as drugs used in chemotherapy; immunotherapy; or radiation.

Patient EducationClinical

Optic Nerve Disorders

The optic nerve is a bundle of more than 1 million nerve fibers that carry visual messages. You have one connecting the back of each eye (your retina) to your brain. Damage to an optic nerve can cause vision loss. The type of vision loss and how severe it is depends on where the damage occurs. It may affect one or both eyes.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert H46.3 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
377.34 Toxic optic neuropathy
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About H46.3Overview

What is the ICD-10 code for toxic optic neuropathy?

The ICD-10-CM code for toxic optic neuropathy is H46.3 (sometimes written as H463). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is H46.3 (Optic neuritis) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report toxic optic neuropathy on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does H46.3 group to?

When toxic optic neuropathy is the principal diagnosis on an inpatient stay, it groups to MS-DRG 123 (neurological Eye Disorders), which carries a relative weight of 0.8218. Higher weights mean higher Medicare reimbursement.

What is coded first with H46.3?

The Code First note reads: (T51-T65) to identify cause. When one of these applies, it is sequenced before H46.3.

What is the ICD-9 equivalent of H46.3?

Under the General Equivalence Mappings, toxic optic neuropathy converts to ICD-9-CM 377.34 (toxic optic neuropathy). The mapping is a direct match.