H46.02 ICD-10-CM Code: Optic papillitis, left eye

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for H46.02 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on H46.02 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for H46.02

MedCoder structured workflow — derived from this code’s own official record

Before you code H46.02

1. Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: left). The unspecified-side code applies only when the record states no side. Laterality is assigned from the documented side; where a bilateral code exists and both sides are documented, it is used instead of two unilateral codes (Guidelines I.B.13).

   ReviewH46.01 · right, H46.03 · bilateral, H46.00 · unspecified

   Guide: Laterality coding →

Choose the right path

1. Is the side documented?
   Yes → Select the code for the documented side (or the bilateral code when both sides are documented and one exists).
   No → Use the unspecified-side code only when the record states no side; a query is the alternative.

   ReviewH46.01 · right, H46.03 · bilateral, H46.00 · unspecified

Consider H46.02. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Laterality

Right, left or bilateral as documented; unspecified only when the record states no side (Guidelines I.B.13).

Official instructions as workflow

• Excludes2 — not part of H46.02(2 notes)

  Coding workflow: The conditions named in this note are not included in H46.02. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareH47.01

  See the official tabular notes · Guidelines I.A.12.b

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse H46.02 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of H46.02 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• H46.00— Specificity relationship (Review)

  Overlapping diagnoses in the same category.

  Overlapping codes in the same category — the documentation decides which is the more specific fit.

  What moves you there: A record that documents no more than “Optic papillitis, unspecified eye” takes H46.00; specificity in the record moves it back here.

  Full comparison: H46.02 vs H46.00 →

• H46.01— Laterality relationship (Review)

  Same condition; these differ only in which side is documented.

  The same condition on the other side; the documented side decides, and a bilateral code, where one exists, replaces the pair when both sides are documented.

  What moves you there: A documented right side moves the case to H46.01.

  Full comparison: H46.02 vs H46.01 →

• H46.03— Laterality relationship (Review)

  Same condition; these differ only in which side is documented.

  The same condition on the other side; the documented side decides, and a bilateral code, where one exists, replaces the pair when both sides are documented.

  What moves you there: Documentation of both sides moves the case to H46.03.

  Full comparison: H46.02 vs H46.03 →

• H47.01— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of ischemic optic neuropathy adds H47.01; it is not part of this code and both may be reported when both are documented.

  Full comparison: H46.02 vs H47.01 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Verify Before Coding

• CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 12 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 1 MS-DRG: DRG 123 (MDC 02).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):EYE006 — Neuro-ophthalmology (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

H46.00 — Optic papillitis, unspecified eye, H46.01 — Optic papillitis, right eye, H46.03 — Optic papillitis, bilateral, H46.10 — Retrobulbar neuritis, unspecified eye, H46.11 — Retrobulbar neuritis, right eye, H46.12 — Retrobulbar neuritis, left eye, H46.13 — Retrobulbar neuritis, bilateral, H46.2 — Nutritional optic neuropathy, H46.3 — Toxic optic neuropathy, H46.8 — Other optic neuritis, H46.9 — Unspecified optic neuritis

Same condition, opposite side

Same category and title, differing only in which side of the body is affected.

H46.00 — Optic papillitis, unspecified eye (unspecified)Compare H46.02 vs H46.00 →, H46.01 — Optic papillitis, right eye (right)Compare H46.02 vs H46.01 →, H46.03 — Optic papillitis, bilateral (bilateral)Compare H46.02 vs H46.03 →

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Neuro-ophthalmology).

A39.82 — Meningococcal retrobulbar neuritis, A50.44 — Late congenital syphilitic optic nerve atrophy, H46.00 — Optic papillitis, unspecified eye, H46.01 — Optic papillitis, right eye, H46.03 — Optic papillitis, bilateral, H46.10 — Retrobulbar neuritis, unspecified eye, H46.11 — Retrobulbar neuritis, right eye, H46.12 — Retrobulbar neuritis, left eye, H46.13 — Retrobulbar neuritis, bilateral, H46.2 — Nutritional optic neuropathy, H46.3 — Toxic optic neuropathy, H46.8 — Other optic neuritis, H46.9 — Unspecified optic neuritis, H47.011 — Ischemic optic neuropathy, right eye, H47.012 — Ischemic optic neuropathy, left eye, H47.013 — Ischemic optic neuropathy, bilateral, H47.019 — Ischemic optic neuropathy, unspecified eye, H47.021 — Hemorrhage in optic nerve sheath, right eye, H47.022 — Hemorrhage in optic nerve sheath, left eye, H47.023 — Hemorrhage in optic nerve sheath, bilateral, +108 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Papillitis”; these codes share that main term but sit in a different category of the Tabular List.

K14.0 — Glossitis (tongue), K14.4 — Atrophy of tongue papillae (chronic lingual), K62.89 — Other specified diseases of anus and rectum (anus), N17.2 — Acute kidney failure with medullary necrosis (renal, necrotizing)

Contextual Map

Every relationship of H46.02 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

• H00-H59 — Chapter 7: Diseases of the Eye and Adnexa (H00-H59) (H00-H59)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H46-H47 — Disorders of optic nerve and visual pathways[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Clinical classification (CCSR)

• EYE006 — Neuro-ophthalmology[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

MS-DRG Grouper

• CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2026
• DRG 123 — NEUROLOGICAL EYE DISORDERS[MS-DRG]: “NEUROLOGICAL EYE DISORDERS (MDC 02)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

• MDC 02 — Diseases and Disorders of the Eye[MDC crossing]: “Diseases and Disorders of the Eye — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1,200 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Nearest codes (14)

• H46 — Optic neuritis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H46.0 — Optic papillitis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H46.00 — Optic papillitis, unspecified eye[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H46.01 — Optic papillitis, right eye[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H46.03 — Optic papillitis, bilateral[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H46.1 — Retrobulbar neuritis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H46.10 — Retrobulbar neuritis, unspecified eye[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H46.11 — Retrobulbar neuritis, right eye[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 6 more

Change history

• FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Inpatient payment groups Official source data

CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to H46.02 in its code family, with their registry titles.

• H46 — Optic neuritis
• H46.0 — Optic papillitis
• H46.00 — Optic papillitis, unspecified eye
• H46.01 — Optic papillitis, right eye
• H46.03 — Optic papillitis, bilateral
• H46.1 — Retrobulbar neuritis
• H46.10 — Retrobulbar neuritis, unspecified eye
• H46.11 — Retrobulbar neuritis, right eye
• H46.12 — Retrobulbar neuritis, left eye
• H46.13 — Retrobulbar neuritis, bilateral

View all codes in the H46 family