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H49 vs H51.2

H49 (Paralytic strabismus) compared with H51.2 (Internuclear ophthalmoplegia), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).

Can these codes be reported together?

Yes, when both are documented. H49 carries an Excludes2 note covering H51.2: “internuclear ophthalmoplegia (H51.2-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

H49Paralytic strabismusH51.2Internuclear ophthalmoplegia
Billing statusNon-billable header

Report instead: H49.00, H49.01, H49.02, H49.03, H49.10

Non-billable header

Report instead: H51.20, H51.21, H51.22, H51.23

ClassificationH00-H59 — Diseases of the Eye and Adnexa (H00-H59)H00-H59 — Diseases of the Eye and Adnexa (H00-H59)
DefinitionParalytic strabismus is a non-billable ICD-10-CM category code (H49).Internuclear ophthalmoplegia is a non-billable ICD-10-CM category code (H51.2).
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Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources