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H21.562

Billable

Pupillary abnormality, left eye

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

What This Code Means

The pupil (the dark center part of the eye) in the left eye is not functioning or appearing normally, which can affect how light enters the eye and how well vision works. This could involve the pupil being an unusual size, shape, or not responding properly to light.

Coding Tips

  • •Verify documentation specifies the left eye (H21.562) versus right eye (H21.561) or bilateral (H21.56) to ensure accurate laterality coding
  • •Review clinical notes to determine the specific type of pupillary abnormality (such as Adie's pupil, Argyll Robertson pupil, or other specified abnormalities) as more specific codes may be available under H21.56-

Code Hierarchy

└H21Other disorders of iris and ciliary body└H21.5Other and unspecified adhesions and disruptions of iris and ciliary body└H21.56Pupillary abnormalities└H21.562Pupillary abnormality, left eye
└H21.562Pupillary abnormality, left eye

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