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  2. ICD-10-CM Codes List
  3. H00–H59
  4. H46-H47
  5. Optic neuritis (H46)

Optic neuritis (H46)

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.

Instructional Notations

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.

  • ischemic optic neuropathy H47.01
  • neuromyelitis optica [Devic] G36.0

Clinical Terms

The following clinical terms provide additional context, helping users better understand the clinical background and common associations for each diagnosis listed in this section. Including related terms alongside ICD-10-CM codes supports coders, billers, and healthcare professionals in improving accuracy, enhancing documentation, and facilitating research or patient education.

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.