2026 ICD-10-CM Diagnosis Code H54.511ALow vision right eye category 1, normal vision left eye

ICD-10-CM Codes›H00–H59›H53-H54›H54

ICD-10-CM H54.511A
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

H54.511A is a billable ICD-10-CM diagnosis code for low vision right eye category 1, normal vision left eye. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) 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

ICD-10-CM Code
H54.511A
Billable Status
Yes — Valid for Submission
Code Describes
Low vision right eye category 1, normal vision left eye
Short Description
Low vision right eye category 1, normal vision left eye
Same as the full description in the CMS dataset.
Parent Code
H54.511
Low vision, right eye, category 1

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH53-H54Visual disturbances and blindness
CategoryH54Blindness and low vision
This CodeH54.511ALow vision right eye category 1, normal vision left eye

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Low
      • vision
        • one eye (other eye normal)
          • right (normal vision on left)
            • category 1

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR EYE010
Blindness and vision defects
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Vision Impairment and Blindness

Vision impairment is the loss of vision. It includes blindness, which means that you have lost all or most of your sight. It also includes low vision, which means you have some vision, but the vision loss makes it hard to do everyday activities. You may have trouble reading, shopping, cooking, writing, and watching TV.

The full article covers:

  • What is vision impairment?
  • What causes vision impairment?
  • How is vision impairment diagnosed?
  • What are the types of low vision?
  • What are the treatments for low vision?
  • How can I make the most of my remaining sight?
  • Can vision impairment be prevented?

Read the full article at MedlinePlus

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

Convert H54.511A to ICD-9-CMHistory

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

ICD-9-CM
369.76 One eye-mod/oth normal
Approximate The match is approximate rather than exact.

Code History & ChangesHistory

Replacement H54.511A replaces the following previously assigned code(s):

  • H54.51 - Low vision, right eye, normal vision left eye
FY 2018AddedAdded to the ICD-10-CM code setEffective October 1, 2017.
FY 2019–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About H54.511AOverview

Is H54.511A (Low vision, right eye, category 1) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report low vision right eye category 1, normal vision left eye on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character A in H54.511A mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for low vision, right eye, category 1, such as an emergency visit or first evaluation.

What MS-DRG does H54.511A group to?

When low vision right eye category 1, normal vision left eye is the principal diagnosis on an inpatient stay, it groups to MS-DRG 124, 125, with relative weights from 0.7678 to 1.3231 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of H54.511A?

Under the General Equivalence Mappings, low vision right eye category 1, normal vision left eye converts to ICD-9-CM 369.76 (one eye-mod/oth normal). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.