2027 ICD-10-CM Diagnosis Code H49Paralytic strabismus

ICD-10-CM Codes›H00–H59›H49-H52›H49

ICD-10-CM H49
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

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

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to H49: its own notes plus those printed at block H49-H52 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.

On H49 itself
  • internal ophthalmoplegia (H52.51-)
  • internuclear ophthalmoplegia (H51.2-)
  • progressive supranuclear ophthalmoplegia (G23.1)
From Block H49-H52 Disorders of ocular muscles, binocular movement, accommodation and refraction applies to 150 codes
  • nystagmus and other irregular eye movements (H55)
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)

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.

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 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About H49Overview

What is the ICD-10 code for paralytic strabismus?

H49 is the ICD-10-CM category for paralytic strabismus, but it is a non-billable header: claims need a more specific code from this category, listed on this page.

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.