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H54 ICD-10-CM Code: Blindness and low vision

ICD-10-CM Code View

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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Visual disturbances and blindness (H53-H54)

H54

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Blindness and low vision

Blindness and low vision

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

Official
H5Visual disturbances and blindness (H53-H54)
H54Blindness and low vision

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H54 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H54 in this effective period.

Related Child Codes

Official
H54.0Blindness, both eyes
H54.1Blindness, one eye, low vision other eye
H54.2Low vision, both eyes
H54.3Unqualified visual loss, both eyes
H54.4Blindness, one eye

Includes

Official

ICD-10-CM does not list Includes notes for H54 in this effective period.

Excludes 1

Official
  • amaurosis fugax (G45.3)

Code First

Official
  • any associated underlying cause of the blindness

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H54 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H54 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Coder workflow notes

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What This Code Means

H54 is the ICD-10-CM diagnosis code for blindness and low vision. H54 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering visual disturbances and blindness (h53-h54).

Header codes like H54 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at H54's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H54 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

Code First

  • any associated underlying cause of the blindness

Child Codes

Code Hierarchy

H54Blindness and low vision
H54Blindness and low vision

Work H54 in HCC Buddy

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