ICD-10 H54
Non-Billable HeaderBlindness and low vision
About ICD-10-CM H54
ICD-10-CM code H54 represents Blindness and low vision. This is a non-billable header code in the Eye and Adnexa chapter (block H54). The 2026 edition of ICD-10-CM H54 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with H54. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- amaurosis fugax (G45.3)
Coding Notes
Code First
- any associated underlying cause of the blindness
Medicare LCD Coverage for H54
Local Coverage Determinations (LCDs) from CMS MACs that list H54 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing H54.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but H54 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with H54
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
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.
Codes Adjacent To H54
Other codes in section H53-H54 (Visual disturbances and blindness).
ICD-10 H54, Billing FAQ
Is ICD-10 code H54 billable? +
No, H54 is a non-billable header code. Use a more specific child code from block H54 when submitting claims.
What codes are Type 1 Excludes for H54? +
Type 1 Excludes (never code together with H54): amaurosis fugax (G45.3)
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team