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H05.249

Billable

Constant exophthalmos, unspecified eye

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

The eye is permanently pushed forward out of its socket due to an underlying condition, but the specific cause or which eye is affected is not documented. This constant bulging of the eye can affect vision and eye comfort.

Coding Tips

  • Use this code only when the provider documents exophthalmos as constant/persistent but does not specify the underlying cause (such as thyroid disease, tumor, or inflammation) or does not specify laterality (right, left, or bilateral)
  • If the cause is known (e.g., thyroid-related exophthalmos), code the underlying condition first and use a more specific H05.24- code with laterality; query the provider if the eye affected is not documented

Code Hierarchy

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