2027 ICD-10-CM Diagnosis Code H49.9Unspecified paralytic strabismus

ICD-10-CM Codes›H00–H59›H49-H52›H49

ICD-10-CM H49.9
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

H49.9 is a billable ICD-10-CM diagnosis code for unspecified paralytic strabismus. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 123. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Neuro-ophthalmology and Strabismus.

Code Identity

ICD-10-CM Code
H49.9
Billable Status
Yes — Valid for Submission
Code Describes
Unspecified paralytic strabismus
Short Description
Unspecified paralytic strabismus
Same as the full description in the CMS dataset.
Parent Code
H49
Paralytic strabismus

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH49-H52Disorders of ocular muscles, binocular movement, accommodation and refraction
CategoryH49Paralytic strabismus
This CodeH49.9Unspecified paralytic strabismus

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Acquired dysarthria
  • Combined malformation of central nervous system and skeletal muscle
  • Congenital nuclear ophthalmoplegia
  • Congenital plicated tongue
  • Gaucher disease with ophthalmoplegia and cardiovascular calcification
  • Gaucher's disease
  • Hereditary inclusion body myopathy, joint contracture, ophthalmoplegia syndrome
  • Hutchinson's facies
  • Myopathy with cytoplasmic inclusions
  • Ophthalmoplegia
  • Ophthalmoplegia due to abetalipoproteinemia
  • Ophthalmoplegia due to and following Guillain-Barré syndrome
  • Ophthalmoplegia due to neuropathy
  • Ophthalmoplegia due to phytanic acid storage disease
  • Ophthalmoplegia, intellectual disability, lingua scrotalis syndrome
  • Paralysis of tongue
  • Paralytic strabismus
  • Paralytic strabismus of bilateral eyes
  • Paralytic strabismus of left eye
  • Paralytic strabismus of right eye
  • Paresis of extraocular muscles
  • Plicated tongue
  • Sensory ataxia
  • Sensory ataxic neuropathy with dysarthria and ophthalmoparesis syndrome
  • Sequela of Guillain Barre syndrome
  • Spinal atrophy, ophthalmoplegia, pyramidal syndrome
  • Subacute neuronopathic Gaucher's disease

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to H49.9: its own notes plus those printed at H49, 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.

From H49 Paralytic strabismus applies to 29 codes
  • 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.

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 EYE006
Neuro-ophthalmology
Default principal diagnosis: inpatient Yes · outpatient Yes
CCSR EYE007
Strabismus
Default principal diagnosis: inpatient No · outpatient No

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.

Convert H49.9 to ICD-9-CMHistory

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

ICD-9-CM
378.50 Paralytic strabismus NOS
Approximate The match is approximate rather than exact.

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 H49.9Overview

What is the ICD-10 code for unspecified paralytic strabismus?

The ICD-10-CM code for unspecified paralytic strabismus is H49.9 (sometimes written as H499). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is H49.9 (Paralytic strabismus) a billable code?

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

What MS-DRG does H49.9 group to?

When unspecified paralytic strabismus 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 the ICD-9 equivalent of H49.9?

Under the General Equivalence Mappings, unspecified paralytic strabismus converts to ICD-9-CM 378.50 (paralytic strabismus NOS). The mapping is approximate, so confirm the match fits the documentation.