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

ICD-10 H53.412

Billable / Specific

Scotoma involving central area, left eye

H53
Block
0
Synonyms
351
LCDs
24
Payer Policies
0
Linked CPTs

About ICD-10-CM H53.412

ICD-10-CM code H53.412 represents Scotoma involving central area, left eye. This is a billable/specific code in the Eye and Adnexa chapter (block H53). The 2026 edition of ICD-10-CM H53.412 became effective on October 1, 2025.

Medicare LCD Coverage for H53.412

Local Coverage Determinations (LCDs) from CMS MACs that list H53.412 as a covered diagnosis.

351 LCDs

Showing top 10 of 351 total . 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 →
CMS LCD: Billing and Coding: Electroretinography (ERG)
Article ID: 57677, Effective: 2024-10-01 00:00:00, 653 covered, 1 non-covered
CPT 92274 →
CMS LCD: Billing and Coding: Electroretinography (ERG)
Article ID: 57677, Effective: 2024-10-01 00:00:00, 653 covered, 1 non-covered
CPT 0509T →
CMS LCD: Billing and Coding: Electroretinography (ERG)
Article ID: 57677, Effective: 2024-10-01 00:00:00, 653 covered, 1 non-covered
CPT 92273 →
CMS LCD: Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Article ID: 57804, Effective: 2025-10-01 00:00:00, 725 covered, 1 non-covered
CPT 92134 →
CMS LCD: Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Article ID: 57804, Effective: 2025-10-01 00:00:00, 725 covered, 1 non-covered
CPT 92132 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing H53.412.

24 policies

5 Medicare

Billing and Coding: Home Health Occupational Therapy
Policy ID: ART-53057
Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Policy ID: ART-53060
Billing and Coding: Outpatient Occupational Therapy
Policy ID: ART-53064
Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Policy ID: ART-56537
Billing and Coding: Visual Fields Testing
Policy ID: ART-56551

CPT Codes Commonly Billed with H53.412

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

No procedure linkages on file for H53.412

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 H53.412 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
H53.412 36841 10000

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

ICD-10 H53.412, Billing FAQ

Is ICD-10 code H53.412 billable? +

Yes, H53.412 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What ICD-9 codes does H53.412 map to? +

Per CMS GEMs, H53.412 maps to ICD-9 codes: 36841. 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 May 31, 2026.

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