2026 ICD-10-CM Diagnosis Code H49Paralytic strabismus

ICD-10-CM Codes›H00–H59›H49-H52›H49

ICD-10-CM H49
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

H49 is a non-billable ICD-10-CM category code for paralytic strabismus, so it cannot be submitted on claims. Use a more specific code from this category instead, such as H49.00, H49.01, H49.02, and H49.03.

Code Identity

ICD-10-CM Code
H49
Billable Status
No — Non-Billable Category
Code Describes
Paralytic strabismus
Short Description
Paralytic strabismus
Same as the full description in the CMS dataset.
Chapter
H49-H52
Disorders of ocular muscles, binocular movement, accommodation and refraction

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH49-H52Disorders of ocular muscles, binocular movement, accommodation and refraction
CategoryH49Paralytic strabismus
This CodeH49Paralytic strabismus

Specific Coding for Paralytic strabismusOverview

Non-specific codes like H49 require more characters. Use one of these billable codes instead:

  • H49.0 for Third [oculomotor] nerve palsy

  • Use H49.00 for Third [oculomotor] nerve palsy, unspecified eye

  • Use H49.01 for Third [oculomotor] nerve palsy, right eye

  • Use H49.02 for Third [oculomotor] nerve palsy, left eye

  • Use H49.03 for Third [oculomotor] nerve palsy, bilateral

  • H49.1 for Fourth [trochlear] nerve palsy

  • Use H49.10 for Fourth [trochlear] nerve palsy, unspecified eye

  • Use H49.11 for Fourth [trochlear] nerve palsy, right eye

  • Use H49.12 for Fourth [trochlear] nerve palsy, left eye

  • Use H49.13 for Fourth [trochlear] nerve palsy, bilateral

  • H49.2 for Sixth [abducent] nerve palsy

  • Use H49.20 for Sixth [abducent] nerve palsy, unspecified eye

  • Use H49.21 for Sixth [abducent] nerve palsy, right eye

  • Use H49.22 for Sixth [abducent] nerve palsy, left eye

  • Use H49.23 for Sixth [abducent] nerve palsy, bilateral

  • H49.3 for Total (external) ophthalmoplegia

  • Use H49.30 for Total (external) ophthalmoplegia, unspecified eye

  • Use H49.31 for Total (external) ophthalmoplegia, right eye

  • Use H49.32 for Total (external) ophthalmoplegia, left eye

  • Use H49.33 for Total (external) ophthalmoplegia, bilateral

  • H49.4 for Progressive external ophthalmoplegia

  • Use H49.40 for Progressive external ophthalmoplegia, unspecified eye

  • Use H49.41 for Progressive external ophthalmoplegia, right eye

  • Use H49.42 for Progressive external ophthalmoplegia, left eye

  • Use H49.43 for Progressive external ophthalmoplegia, bilateral

  • H49.8 for Other paralytic strabismus

  • H49.81 for Kearns-Sayre syndrome

  • H49.88 for Other paralytic strabismus

  • Use H49.9 for Unspecified paralytic strabismus

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Type 2 Excludes

  • internal ophthalmoplegia H52.51
  • internuclear ophthalmoplegia H51.2
  • progressive supranuclear ophthalmoplegia G23.1

Patient EducationClinical

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.

Read the full article at MedlinePlus

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

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About H49Overview

Is H49 (Paralytic strabismus) a billable code?

No. This is a category header that groups the codes for paralytic strabismus, and headers cannot be submitted on claims. Claims for paralytic strabismus need a more specific code from this category, such as H49.00, H49.01, and H49.02.