H52.00 ICD-10-CM Code: Hypermetropia, unspecified eye

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for H52.00 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 H52.00 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for H52.00

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

Before you code H52.00

1. Unspecified does not mean incorrect. When the record gives no greater specificity, H52.00 may be the appropriate code. Check the record for detail that supports a more specific sibling. An unspecified code is for records that do not provide the detail a more specific code needs; a query, not an assumption, is the route to specificity (Guidelines I.A.9.b, I.B.18).

   ReviewH52.01, H52.02, H52.03

   See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

2. Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: unspecified). 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).

   ReviewH52.01 · right, H52.02 · left

   Guide: Laterality coding →

Choose the right path

1. Does the record document the detail a more specific sibling code needs?
   Yes → Review the specific siblings in this subcategory.
   No → Continue — H52.00 is appropriate when the documentation goes no further.

   ReviewH52.01, H52.02, H52.03

2. 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.

   ReviewH52.01 · right, H52.02 · left

Consider H52.00. 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).

Any detail beyond this code’s title

What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

• Excludes2 — not part of H52.00(1 note)

  Coding workflow: The conditions named in this note are not included in H52.00. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareH55

  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 H52.00 with…

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

The codes most likely to be picked instead of H52.00 — 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.

• H52.01— 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 H52.01.

  Full comparison: H52.00 vs H52.01 →

• H52.02— 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 left side moves the case to H52.02.

  Full comparison: H52.00 vs H52.02 →

• H55— 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 nystagmus and other irregular eye movements adds H55; it is not part of this code and both may be reported when both are documented.

  Full comparison: H52.00 vs H55 →

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

• No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

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: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 2 MS-DRGs: DRG 124 (MDC 02), DRG 125 (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):EYE009 — Refractive error (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 condition, opposite side

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

H52.01 — Hypermetropia, right eye (right)Compare H52.00 vs H52.01 →, H52.02 — Hypermetropia, left eye (left)Compare H52.00 vs H52.02 →

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Refractive error).

H52.01 — Hypermetropia, right eye, H52.02 — Hypermetropia, left eye, H52.03 — Hypermetropia, bilateral, H52.10 — Myopia, unspecified eye, H52.11 — Myopia, right eye, H52.12 — Myopia, left eye, H52.13 — Myopia, bilateral, H52.201 — Unspecified astigmatism, right eye, H52.202 — Unspecified astigmatism, left eye, H52.203 — Unspecified astigmatism, bilateral, H52.209 — Unspecified astigmatism, unspecified eye, H52.211 — Irregular astigmatism, right eye, H52.212 — Irregular astigmatism, left eye, H52.213 — Irregular astigmatism, bilateral, H52.219 — Irregular astigmatism, unspecified eye, H52.221 — Regular astigmatism, right eye, H52.222 — Regular astigmatism, left eye, H52.223 — Regular astigmatism, bilateral, H52.229 — Regular astigmatism, unspecified eye, H52.31 — Anisometropia, +16 more

Contextual Map

Every relationship of H52.00 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
• H49-H52 — Disorders of ocular muscles, binocular movement, accommodation and refraction[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Clinical classification (CCSR)

• EYE009 — Refractive error[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

MS-DRG Grouper

• DRG 124 — OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT[MS-DRG]: “OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT (MDC 02)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 125 — OTHER DISORDERS OF THE EYE WITHOUT MCC[MS-DRG]: “OTHER DISORDERS OF THE EYE WITHOUT MCC (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 (40)

• H52 — Disorders of refraction and accommodation[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H52.0 — Hypermetropia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H52.01 — Hypermetropia, right eye[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H52.02 — Hypermetropia, left eye[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H52.03 — Hypermetropia, bilateral[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H52.1 — Myopia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H52.10 — Myopia, unspecified eye[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H52.11 — Myopia, right eye[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 32 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 H52.00 in its code family, with their registry titles.

• H52 — Disorders of refraction and accommodation
• H52.0 — Hypermetropia
• H52.01 — Hypermetropia, right eye
• H52.02 — Hypermetropia, left eye
• H52.03 — Hypermetropia, bilateral
• H52.1 — Myopia
• H52.10 — Myopia, unspecified eye
• H52.11 — Myopia, right eye
• H52.12 — Myopia, left eye
• H52.13 — Myopia, bilateral

View all codes in the H52 family