H49.20 ICD-10-CM Code: Sixth [abducent] nerve palsy, unspecified eye
H49.20 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of ocular muscles, binocular movement, accommodation and refraction (H49-H52)
H49.20
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceSixth [abducent] nerve palsy, unspecified eye
Paralysis of the sixth cranial nerve (abducent nerve) with unspecified eye involvement, causing inability to move the affected eye outward (laterally).
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for H49.20. Check the code and parent instructions in the Code Book.
Excludes 2
Official- certain conditions originating in the perinatal period (P04-P96)Inherited from H00-H59, H49-H52, H49
- certain infectious and parasitic diseases (A00-B99)Inherited from H00-H59, H49-H52, H49
- complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from H00-H59, H49-H52, H49
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from H00-H59, H49-H52, H49
- diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)Inherited from H00-H59, H49-H52, H49
- endocrine, nutritional and metabolic diseases (E00-E88)Inherited from H00-H59, H49-H52, H49
- injury (trauma) of eye and orbit (S05.-)Inherited from H00-H59, H49-H52, H49
- injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from H00-H59, H49-H52, H49
- neoplasms (C00-D49)Inherited from H00-H59, H49-H52, H49
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from H00-H59, H49-H52, H49
- syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)Inherited from H00-H59, H49-H52, H49
- nystagmus and other irregular eye movements (H55)Inherited from H00-H59, H49-H52, H49
- internal ophthalmoplegia (H52.51-)Inherited from H00-H59, H49-H52, H49
- internuclear ophthalmoplegia (H51.2-)Inherited from H00-H59, H49-H52, H49
- progressive supranuclear ophthalmoplegia (G23.1)Inherited from H00-H59, H49-H52, H49
Related Codes
Includes
OfficialNo Includes notes are included in this display for H49.20. Check the code and parent instructions in the Code Book.
Excludes 1
OfficialNo Excludes 1 notes are included in this display for H49.20. Check the code and parent instructions in the Code Book.
Code First
OfficialNo Code First sequencing instructions are included in this display for H49.20. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for H49.20. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for H49.20. Check the code and parent instructions in the Code Book.
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 H49.20 an HCC code?
No. H49.20 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- H49.20
- Description
- Sixth [abducent] nerve palsy, unspecified eye
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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What This Code Means
H49.20 is the ICD-10-CM diagnosis code for sixth [abducent] nerve palsy, unspecified eye. Paralysis of the sixth cranial nerve (abducent nerve) with unspecified eye involvement, causing inability to move the affected eye outward (laterally). H49.20 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering disorders of ocular muscles, binocular movement, accommodation and refraction (h49-h52).
H49.20 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.
Use this code only when laterality cannot be determined from documentation.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for H49.20 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.