2026 ICD-10-CM Diagnosis Code H57.04Mydriasis

ICD-10-CM Codes›H00–H59›H55-H57›H57

ICD-10-CM H57.04
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

H57.04 is a billable ICD-10-CM diagnosis code for mydriasis. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified eye disorders.

Code Identity

ICD-10-CM Code
H57.04
Billable Status
Yes — Valid for Submission
Code Describes
Mydriasis
Short Description
Mydriasis
Same as the full description in the CMS dataset.
Parent Code
H57.0
Anomalies of pupillary function

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH55-H57Other disorders of eye and adnexa
CategoryH57Other disorders of eye and adnexa
This CodeH57.04Mydriasis

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Bilateral fixed dilatation of pupil
  • Congenital mydriasis
  • Dilated pupil
  • Episodic mydriasis due to parasympathetic insufficiency
  • Episodic mydriasis due to sympathetic hyperactivity
  • Episodic mydriasis of left pupil
  • Episodic mydriasis of right pupil
  • Fixed dilatation of left pupil
  • Fixed dilatation of pupil
  • Fixed dilatation of right pupil
  • Mydriasis innervational defect
  • Mydriasis not due to mydriatic eye drop
  • Persistent mydriasis
  • Traumatic mydriasis

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.

    • Anomaly, anomalous(congenital) (unspecified type)
      • pupil
        • function
          • mydriasis
    • Dilatation
      • pupil
    • Mydriasis(pupil)

Clinical ClassificationClinical

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

CCSR EYE012
Other specified eye disorders
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Mydriasis

    dilation of pupils to greater than 6 mm combined with failure of the pupils to constrict when stimulated with light. this condition may occur due to injury of the pupillary fibers in the oculomotor nerve, in acute angle-closure glaucoma, and in adie syndrome.

  • Adie Syndrome

    a syndrome characterized by a tonic pupil that occurs in combination with decreased lower extremity reflexes. the affected pupil will respond more briskly to accommodation than to light (light-near dissociation) and is supersensitive to dilute pilocarpine eye drops, which induce pupillary constriction. pathologic features include degeneration of the ciliary ganglion and postganglionic parasympathetic fibers that innervate the pupillary constrictor muscle. (from adams et al., principles of neurology, 6th ed, p279)

  • Mydriasis

    the pupil(s) are dilated.

Patient EducationClinical

Eye Diseases

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Read the full article at MedlinePlus

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

Convert H57.04 to ICD-9-CMHistory

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

ICD-9-CM
379.43 Mydriasis not d/t mydrtc
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About H57.04Overview

Is H57.04 (Anomalies of pupillary function) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report mydriasis on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What is the ICD-9 equivalent of H57.04?

Under the General Equivalence Mappings, mydriasis converts to ICD-9-CM 379.43 (mydriasis not d/t mydrtc). The mapping is a direct match.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.