Optic neuritis (H46) ICD-10-CM
The H46 code range covers optic neuritis with 15 ICD-10-CM diagnosis codes. 12 of them are billable and valid for claim submission in fiscal year 2026, and the category headers group them but cannot themselves be billed.
Type 2 Excludes
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
Codes in the H46 Range 15 codes · 12 billable
- H46 Optic neuritisNon-billable
- H46.0 Optic papillitisNon-billable
- H46.00 Optic papillitis, unspecified eye
- H46.01 Optic papillitis, right eye
- H46.02 Optic papillitis, left eye
- H46.03 Optic papillitis, bilateral
- H46.1 Retrobulbar neuritisNon-billable
- H46.10 Retrobulbar neuritis, unspecified eye
- H46.11 Retrobulbar neuritis, right eye
- H46.12 Retrobulbar neuritis, left eye
- H46.13 Retrobulbar neuritis, bilateral
- H46.2 Nutritional optic neuropathy
- H46.3 Toxic optic neuropathy
- H46.8 Other optic neuritis
- H46.9 Unspecified optic neuritis
Clinical Terms in This Code Range
Definitions from the National Library of Medicine for conditions coded in the H46 range.
Multiple Sclerosis
An autoimmune disorder mainly affecting young adults and characterized by destruction of myelin in the central nervous system. Pathologic findings include multiple sharply demarcated areas of demyelination throughout the white matter of the central nervous system. Clinical manifestations include visual loss, extra-ocular movement disorders, paresthesias, loss of sensation, weakness, dysarthria, spasticity, ataxia, and bladder dysfunction. The usual pattern is one of recurrent attacks followed by partial recovery (see MULTIPLE SCLEROSIS, RELAPSING-REMITTING), but acute fulminating and chronic progressive forms (see MULTIPLE SCLEROSIS, CHRONIC PROGRESSIVE) also occur. (Adams et al., Principles of Neurology, 6th ed, p903)
Optic Neuritis
Inflammation of the optic nerve. Commonly associated conditions include autoimmune disorders such as MULTIPLE SCLEROSIS, infections, and granulomatous diseases. Clinical features include retro-orbital pain that is aggravated by eye movement, loss of color vision, and contrast sensitivity that may progress to severe visual loss, an afferent pupillary defect (Marcus-Gunn pupil), and in some instances optic disc hyperemia and swelling. Inflammation may occur in the portion of the nerve within the globe (neuropapillitis or anterior optic neuritis) or the portion behind the globe (retrobulbar neuritis or posterior optic neuritis).
Toxic Optic Neuropathy
Damage to the eye or its function (e.g., VISUAL IMPAIRMENT) due to OPTIC NERVE damage secondary to toxic substances such as drugs used in CHEMOTHERAPY; IMMUNOTHERAPY; or RADIATION.
About the H46 Code Range
The ICD-10 codes in the H46 section cover various types of optic neuritis, an inflammation of the optic nerve that can affect one or both eyes. These codes are used to specify the location, cause, and nature of the optic nerve inflammation, aiding accurate diagnosis and treatment documentation.
The general code H46 applies to optic neuritis broadly, while more specific codes like H46.0 identify optic papillitis, inflammation at the optic nerve head. Distinctions include laterality, such as right eye (H46.01), left eye (H46.02), or bilateral involvement (H46.03). Retrobulbar neuritis codes (H46.1 series) are for inflammation behind the eye, with similar laterality distinctions. Nutritional (H46.2) and toxic optic neuropathies (H46.3) reflect optic nerve damage due to nutrient deficiencies or toxins like alcohol or tobacco. Other forms of optic neuritis, including inherited or autoimmune types, fall under H46.8. When the exact nature or cause is unknown, coders use H46.9, which also includes conditions like chronic relapsing inflammatory optic neuropathy. Using these precise codes helps clinicians and coders distinguish between "optic papillitis," "retrobulbar neuritis," and other optic neuritis variants for clear medical communication.
Questions About This Page
How many billable codes are in the H46 range?
Of the 15 codes in this range, 12 are billable and valid for claim submission from October 1, 2025 through September 30, 2026. Category header codes group them but cannot be reported on claims.
What does the H46 range classify?
The range classifies optic neuritis. Each code links to its own reference page with billing status, MS-DRG grouping, coding notes, and clinical information.
Related References
Source: CMS FY 2026 ICD-10-CM Tabular List and order file, effective October 1, 2025 through September 30, 2026.
