ICD-10-CM Code H49

Paralytic strabismus

Version 2021 Non-Billable Code

Not Valid for Submission

H49 is a "header" nonspecific and non-billable code code, consider using a code with a higher level of specificity for a diagnosis of paralytic strabismus. The code is NOT valid for the year 2021 for the submission of HIPAA-covered transactions.

ICD-10:H49
Short Description:Paralytic strabismus
Long Description:Paralytic strabismus

Consider the following ICD-10 codes with a higher level of specificity:

  • H49.0 - Third [oculomotor] nerve palsy
  • H49.00 - Third [oculomotor] nerve palsy, unspecified eye
  • H49.01 - Third [oculomotor] nerve palsy, right eye
  • H49.02 - Third [oculomotor] nerve palsy, left eye
  • H49.03 - Third [oculomotor] nerve palsy, bilateral
  • H49.1 - Fourth [trochlear] nerve palsy
  • H49.10 - Fourth [trochlear] nerve palsy, unspecified eye
  • H49.11 - Fourth [trochlear] nerve palsy, right eye
  • H49.12 - Fourth [trochlear] nerve palsy, left eye
  • H49.13 - Fourth [trochlear] nerve palsy, bilateral
  • H49.2 - Sixth [abducent] nerve palsy
  • H49.20 - Sixth [abducent] nerve palsy, unspecified eye
  • H49.21 - Sixth [abducent] nerve palsy, right eye
  • H49.22 - Sixth [abducent] nerve palsy, left eye
  • H49.23 - Sixth [abducent] nerve palsy, bilateral
  • H49.3 - Total (external) ophthalmoplegia
  • H49.30 - Total (external) ophthalmoplegia, unspecified eye
  • H49.31 - Total (external) ophthalmoplegia, right eye
  • H49.32 - Total (external) ophthalmoplegia, left eye
  • H49.33 - Total (external) ophthalmoplegia, bilateral
  • H49.4 - Progressive external ophthalmoplegia
  • H49.40 - Progressive external ophthalmoplegia, unspecified eye
  • H49.41 - Progressive external ophthalmoplegia, right eye
  • H49.42 - Progressive external ophthalmoplegia, left eye
  • H49.43 - Progressive external ophthalmoplegia, bilateral
  • H49.8 - Other paralytic strabismus
  • H49.81 - Kearns-Sayre syndrome
  • H49.811 - Kearns-Sayre syndrome, right eye
  • H49.812 - Kearns-Sayre syndrome, left eye
  • H49.813 - Kearns-Sayre syndrome, bilateral
  • H49.819 - Kearns-Sayre syndrome, unspecified eye
  • H49.88 - Other paralytic strabismus
  • H49.881 - Other paralytic strabismus, right eye
  • H49.882 - Other paralytic strabismus, left eye
  • H49.883 - Other paralytic strabismus, bilateral
  • H49.889 - Other paralytic strabismus, unspecified eye
  • H49.9 - Unspecified paralytic strabismus

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code H49:

Type 2 Excludes

Type 2 Excludes
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
  • internal ophthalmoplegia H52.51
  • internuclear ophthalmoplegia H51.2
  • progressive supranuclear ophthalmoplegia G23.1

Code Classification

  • Diseases of the eye and adnexa (H00–H59)
    • Disorders of ocular muscles, binocular movement, accommodation and refraction (H49-H52)
      • Paralytic strabismus (H49)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021

Information for Patients


Eye Movement Disorders

When you look at an object, you're using several muscles to move both eyes to focus on it. If you have a problem with the muscles, the eyes don't work properly.

There are many kinds of eye movement disorders. Two common ones are

  • Strabismus - a disorder in which the two eyes don't line up in the same direction. This results in "crossed eyes" or "walleye."
  • Nystagmus - fast, uncontrollable movements of the eyes, sometimes called "dancing eyes"

Some eye movement disorders are present at birth. Others develop over time and may be associated with other problems, such as injuries. Treatments include glasses, patches, eye muscle exercises, and surgery. There is no cure for some kinds of eye movement disorders, such as most kinds of nystagmus.

  • Cranial mononeuropathy III (Medical Encyclopedia)
  • Cranial mononeuropathy VI (Medical Encyclopedia)
  • Eye muscle repair (Medical Encyclopedia)
  • Nystagmus (Medical Encyclopedia)
  • Strabismus (Medical Encyclopedia)
  • Supranuclear ophthalmoplegia (Medical Encyclopedia)

[Learn More]