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H57.0 ICD-10-CM Code: Anomalies of pupillary function

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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Other disorders of eye and adnexa (H55-H57)

H57.0

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

Anomalies of pupillary function

Anomalies of pupillary function

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
H57Other disorders of eye and adnexa
H57.0Anomalies of pupillary function

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H57.0 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H57.0 in this effective period.

Related Child Codes

Official
H57.00Unspecified anomaly of pupillary function
H57.01Argyll Robertson pupil, atypical
H57.02Anisocoria
H57.03Miosis
H57.04Mydriasis

Includes

Official

ICD-10-CM does not list Includes notes for H57.0 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for H57.0 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H57.0 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H57.0 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H57.0 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

H57.0 is the ICD-10-CM diagnosis code for anomalies of pupillary function. H57.0 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering other disorders of eye and adnexa (h55-h57).

Header codes like H57.0 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 H57.0'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 H57.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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