2027 ICD-10-CM Diagnosis Code H57.059Tonic pupil, unspecified eye

ICD-10-CM Codes›H00–H59›H55-H57›H57

ICD-10-CM H57.059
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

H57.059 is a billable ICD-10-CM diagnosis code for tonic pupil, unspecified eye. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 123. Coders also document this condition as absent tendon reflex. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified eye disorders.

Code Identity

ICD-10-CM Code
H57.059
Billable Status
Yes — Valid for Submission
Code Describes
Tonic pupil, unspecified eye
Short Description
Tonic pupil, unspecified eye
Same as the full description in the CMS dataset.
Parent Code
H57.05
Tonic pupil

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH55-H57Other disorders of eye and adnexa
CategoryH57Other disorders of eye and adnexa
This CodeH57.059Tonic pupil, unspecified eye

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Absent tendon reflex
  • Holmes Adie syndrome
  • Light near dissociated pupil
  • Tonic pupillary reaction

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to H57.059: its own notes plus those printed at 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 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.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name H57.059, its category, or a range that includes it.

Applicable To 1

These notes mention H57.059.

  • Z83.51 Family history of eye disorders
    Conditions classifiable to H00-H53, H55-H59 names H55-H59, which includes this code

Excludes2 1

These codes carry an Excludes2 note naming H57.059: its condition is not part of those codes, and both may be reported when the patient has both.

  • R29.2 Abnormal reflex
    abnormal pupillary reflex (H57.0) names H57.0, which includes this code

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

  • Tonic Pupil

    a pupillary abnormality characterized by a poor pupillary light reaction, reduced accommodation, iris sector palsies, an enhanced pupillary response to near effort that results in a prolonged, tonic constriction, and slow pupillary redilation. this condition is associated with injury to the postganglionic parasympathetic innervation to the pupil. (from miller et al., clinical neuro-ophthalmology, 4th ed, pp492-500)

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 H57.059 to ICD-9-CMHistory

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

ICD-9-CM
379.46 Tonic pupillary reaction
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 H57.059Overview

What is the ICD-10 code for tonic pupil, unspecified eye?

The ICD-10-CM code for tonic pupil, unspecified eye is H57.059 (sometimes written as H57059). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is H57.059 (Tonic pupil) a billable code?

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

What MS-DRG does H57.059 group to?

When tonic pupil, unspecified eye 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 H57.059?

Under the General Equivalence Mappings, tonic pupil, unspecified eye converts to ICD-9-CM 379.46 (tonic pupillary reaction). The mapping is approximate, so confirm the match fits the documentation.