ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 A51.43

Billable / Specific CC

Secondary syphilitic oculopathy

A51
Block
3
Synonyms
5
LCDs
1
Payer Policies
0
Linked CPTs

About ICD-10-CM A51.43

ICD-10-CM code A51.43 represents Secondary syphilitic oculopathy. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block A51). The 2026 edition of ICD-10-CM A51.43 became effective on October 1, 2025.

Coding Tips for A51.43

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

A51.43 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under A51.43. Per CMS ICD-10-CM Tabular 2026.

  • Secondary syphilitic chorioretinitis
  • Secondary syphilitic iridocyclitis, iritis
  • Secondary syphilitic uveitis

Inpatient DRG Impact, CC

codes Secondary syphilitic oculopathy. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for A51.43

Local Coverage Determinations (LCDs) from CMS MACs that list A51.43 as a covered diagnosis.

5 LCDs

Showing top 5. Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92201 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92250 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92202 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92227 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92228 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing A51.43.

1 policies

1 Medicare

Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Policy ID: ART-53060

CPT Codes Commonly Billed with A51.43

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for A51.43

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert A51.43 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
A51.43 09150 10000
A51.43 09151 10000
A51.43 09152 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 A51.43, Billing FAQ

Is ICD-10 code A51.43 billable? +

Yes, A51.43 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to A51.43? +

ICD-10 A51.43 includes: Secondary syphilitic chorioretinitis; Secondary syphilitic iridocyclitis, iritis; Secondary syphilitic uveitis.

Is A51.43 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What ICD-9 codes does A51.43 map to? +

Per CMS GEMs, A51.43 maps to ICD-9 codes: 09150, 09151, 09152. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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