2027 ICD-10-CM Diagnosis Code H53.049Amblyopia suspect, unspecified eye
ICD-10-CM Codes›H00–H59›H53-H54›H53
- Billable — Valid for Submission
- Not Chronic
H53.049 is a billable ICD-10-CM diagnosis code for amblyopia suspect, unspecified eye. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 124 through 125. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Blindness and vision defects.
Code Identity
Code Classification
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to H53.049: its own notes plus those printed at H53.0 and Chapter 7. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
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.
- 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.
- 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.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Visual Disturbance
an interference to normal eyesight.
Patient EducationClinical
Amblyopia
Amblyopia, or "lazy eye," is the most common cause of visual impairment in children. It happens when an eye fails to work properly with the brain. The eye may look normal, but the brain favors the other eye. In some cases, it can affect both eyes. Causes include:
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert H53.049 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code History & ChangesHistory
Replacement H53.049 replaces the following previously assigned code(s):
- H53.009 - Unspecified amblyopia, unspecified eye
Questions About H53.049Overview
What is the ICD-10 code for amblyopia suspect, unspecified eye?
The ICD-10-CM code for amblyopia suspect, unspecified eye is H53.049 (sometimes written as H53049). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is H53.049 (Amblyopia suspect) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report amblyopia suspect, unspecified eye on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does H53.049 group to?
When amblyopia suspect, unspecified eye is the principal diagnosis on an inpatient stay, it groups to MS-DRG 125, 124, with relative weights from 0.7699 to 1.2470 depending on complications. Higher weights mean higher Medicare reimbursement.
Can H53.049 be reported with E50.5?
Not as a rule. The Excludes1 note at H53.0, which applies to H53.049, lists "amblyopia due to vitamin A deficiency (E50.5)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
What is the ICD-9 equivalent of H53.049?
Under the General Equivalence Mappings, amblyopia suspect, unspecified eye converts to ICD-9-CM 368.8 (visual disturbances NEC). The mapping is approximate, so confirm the match fits the documentation.