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  6. 2026 ICD-10-CM Code H49

2026 ICD-10-CM Diagnosis Code H49

Paralytic strabismus

ICD-10-CM Code:
H49
ICD-10 Code for:
Paralytic strabismus
Is Billable?
Not Valid for Submission
Code Navigator:

H49 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity from the list below for a diagnosis of paralytic strabismus. The code is not specific and is NOT valid for the year 2026 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

Specific Coding Applicable to Paralytic strabismus

Non-specific codes like H49 require more digits to indicate the appropriate level of specificity. Consider using any of the following billable codes with a higher level of specificity when coding for paralytic strabismus:

  • 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

Code Classification

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

Tabular List of Diseases and Injuries

The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.


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

Patient Education


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.


[Learn More in MedlinePlus]

Code History

  • FY 2026 - No Change, effective from 10/1/2025 through 9/30/2026
  • FY 2025 - No Change, effective from 10/1/2024 through 9/30/2025
  • 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
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.