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

ICD-10 H53.139

Billable / Specific CC

Sudden visual loss, unspecified eye

H53
Block
0
Synonyms
35
LCDs
9
Payer Policies
2
Linked CPTs

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.

Inpatient DRG impact: CC

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.

35 LCDs

Showing top 10 of 35 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Computed Tomography Cerebral Perfusion Analysis (CTP)
Article ID: 60393, Effective: , 46 covered, 0 non-covered
CPT 70472 →
CMS LCD: Billing and Coding: Computed Tomography Cerebral Perfusion Analysis (CTP)
Article ID: 60393, Effective: , 46 covered, 0 non-covered
CPT 70473 →
CMS LCD: Billing and Coding: Non-Invasive Vascular Studies
Article ID: 56697, Effective: 2025-11-06 00:00:00, 1440 covered, 0 non-covered
CPT 93924 →
CMS LCD: Billing and Coding: Non-Invasive Vascular Studies
Article ID: 56697, Effective: 2025-11-06 00:00:00, 1440 covered, 0 non-covered
CPT 93925 →
CMS LCD: Billing and Coding: Non-Invasive Vascular Studies
Article ID: 56697, Effective: 2025-11-06 00:00:00, 1440 covered, 0 non-covered
CPT 93978 →
CMS LCD: Billing and Coding: Non-Invasive Vascular Studies
Article ID: 56697, Effective: 2025-11-06 00:00:00, 1440 covered, 0 non-covered
CPT 93893 →
CMS LCD: Billing and Coding: Non-Invasive Vascular Studies
Article ID: 56697, Effective: 2025-11-06 00:00:00, 1440 covered, 0 non-covered
CPT 93986 →
CMS LCD: Billing and Coding: Non-Invasive Vascular Studies
Article ID: 56697, Effective: 2025-11-06 00:00:00, 1440 covered, 0 non-covered
CPT 93985 →
CMS LCD: Billing and Coding: Non-Invasive Vascular Studies
Article ID: 56697, Effective: 2025-11-06 00:00:00, 1440 covered, 0 non-covered
CPT 93922 →
CMS LCD: Billing and Coding: Non-Invasive Vascular Studies
Article ID: 56697, Effective: 2025-11-06 00:00:00, 1440 covered, 0 non-covered
CPT 93990 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing H53.139.

9 policies

5 Medicare

Billing and Coding: Non-Invasive Vascular Studies
Policy ID: ART-56697
Billing and Coding: Visual Field Examination
Policy ID: ART-57637
Billing and Coding: Non-invasive Extracranial Arterial Studies
Policy ID: ART-57670
Billing and Coding: Computed Tomography Cerebral Perfusion Analysis (CTP)
Policy ID: ART-58152
Billing and Coding: Computed Tomography Cerebral Perfusion Analysis (CTP)
Policy ID: ART-58218

2 Aetna

Transcranial Doppler Ultrasonography
Policy ID: CPB-0353
Cardiovascular Disease Risk Tests
Policy ID: CPB-0381

CPT Codes Commonly Billed with H53.139

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

2 linkages
  • 70473 CMS LCD: Billing and Coding: Computed Tomography Cerebral Perfusion Analysis (CTP) CMS LCD
  • 70472 CMS LCD: Billing and Coding: Computed Tomography Cerebral Perfusion Analysis (CTP) CMS LCD

Convert H53.139 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
H53.139 36811 10000

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

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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