H46.3 ICD-10-CM Code: Toxic optic neuropathy
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of optic nerve and visual pathways (H46-H47)
H46.3
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceToxic optic neuropathy
Damage to the optic nerve caused by exposure to toxic substances such as medications, chemicals, or alcohol.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for H46.3 in this effective period.
Excludes 2
Official- ischemic optic neuropathy (H47.01-)
- neuromyelitis optica [Devic] (G36.0)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H46.3 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H46.3 in this effective period.
Code First
Official- (T51-T65) to identify cause
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H46.3 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H46.3 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is H46.3 an HCC code?
No. H46.3 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- H46.3
- Description
- Toxic optic neuropathy
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
H46.3 is the ICD-10-CM diagnosis code for toxic optic neuropathy. Damage to the optic nerve caused by exposure to toxic substances such as medications, chemicals, or alcohol. H46.3 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering disorders of optic nerve and visual pathways (h46-h47).
H46.3 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Document the specific toxic agent responsible (e.g., ethambutol, methanol, tobacco) in the record.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H46.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific toxic agent responsible (e.g., ethambutol, methanol, tobacco) in the record
- •Code the toxic exposure separately if the substance is identifiable and documented