ICD-10 H54.0
Non-Billable HeaderBlindness, both eyes
About ICD-10-CM H54.0
ICD-10-CM code H54.0 represents Blindness, both eyes. This is a non-billable header code in the Eye and Adnexa chapter (block H54). The 2026 edition of ICD-10-CM H54.0 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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under H54.0. Per CMS ICD-10-CM Tabular 2026.
- Visual impairment categories 3, 4, 5 in both eyes.
Medicare LCD Coverage for H54.0
Local Coverage Determinations (LCDs) from CMS MACs that list H54.0 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 H54.0.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but H54.0 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with H54.0
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.
Convert H54.0 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 |
|---|---|---|
| H54.0 | 36900 | 10000 |
| H54.0 | 36901 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To H54.0
Other codes in section H53-H54 (Visual disturbances and blindness).
ICD-10 H54.0, Billing FAQ
Is ICD-10 code H54.0 billable? +
No, H54.0 is a non-billable header code. Use a more specific child code from block H54 when submitting claims.
What other names or terms map to H54.0? +
ICD-10 H54.0 includes: Visual impairment categories 3, 4, 5 in both eyes..
What ICD-9 codes does H54.0 map to? +
Per CMS GEMs, H54.0 maps to ICD-9 codes: 36900, 36901. 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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