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H53.413

Billable

Scotoma involving central area, bilateral

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

What This Code Means

A scotoma is a blind spot or area of vision loss in the central part of the visual field that affects both eyes. This condition means the patient has difficulty seeing objects directly in front of them in both eyes.

Coding Tips

  • Verify documentation specifies 'bilateral' (both eyes) before assigning this code; if only one eye is affected, use H53.411 (right eye) or H53.412 (left eye) instead
  • Investigate the underlying cause of the scotoma (such as macular degeneration, diabetic retinopathy, or optic nerve disease) and code the etiology separately if documented

Code Hierarchy

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