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H53.423

Billable

Scotoma of blind spot 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 eye. This code describes when both eyes have a scotoma (blind spot) specifically in the area of the natural blind spot, which is the normal area where the optic nerve enters the eye.

Coding Tips

  • Verify documentation specifies bilateral (both eyes) involvement; if only one eye is affected, use H53.421 (right eye) or H53.422 (left eye) instead
  • Ensure the scotoma is specifically documented as being in the blind spot area rather than other locations in the visual field, as different anatomical locations have different codes

Code Hierarchy

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