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H57.09

Billable

Other anomalies of pupillary function

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

What This Code Means

This code describes unusual or abnormal functioning of the pupil (the black circle in the center of the eye) that doesn't fit into other specific categories. The pupil normally changes size in response to light and focus, so this code is used when there are other types of pupil problems beyond the more common ones.

Coding Tips

  • Use this code only when the pupillary anomaly doesn't fit into more specific codes like Adie's syndrome (H57.01) or Argyll Robertson pupils (H57.02)
  • Ensure documentation clearly describes the specific pupillary function abnormality observed during examination, and specify laterality (right eye, left eye, or bilateral) when applicable

Code Hierarchy

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