ICD-10 H53.139
Billable / Specific CCSudden visual loss, unspecified eye
About ICD-10-CM H53.139
ICD-10-CM code H53.139 represents Sudden visual loss, unspecified eye. This is a billable/specific code in the Eye and Adnexa chapter (block H53). The 2026 edition of ICD-10-CM H53.139 became effective on October 1, 2025.
Coding Tips for H53.139
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
H53.139 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.
Inpatient DRG Impact, CC
codes Sudden visual loss, unspecified eye. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for H53.139
Local Coverage Determinations (LCDs) from CMS MACs that list H53.139 as a covered diagnosis.
Showing top 10 of 35 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing H53.139.
5 Medicare
2 Aetna
CPT Codes Commonly Billed with H53.139
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
Convert H53.139 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| H53.139 | 36811 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To H53.139
Other codes in section H53-H54 (Visual disturbances and blindness).
ICD-10 H53.139, Billing FAQ
Is ICD-10 code H53.139 billable? +
Yes, H53.139 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is H53.139 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 CPT codes are commonly billed with H53.139? +
Procedures frequently paired with H53.139 include: 70473, 70472.
What ICD-9 codes does H53.139 map to? +
Per CMS GEMs, H53.139 maps to ICD-9 codes: 36811. 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 2, 2026.
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