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ICD-10/H53.049

H53.049 ICD-10-CM Code: Amblyopia suspect, unspecified eye

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 124 — OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT (MDC 02)
  • MS-DRG 125 — OTHER DISORDERS OF THE EYE WITHOUT MCC (MDC 02)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Official Registry Overview & Definition

Amblyopia suspect, unspecified eye is a billable ICD-10-CM diagnosis code (H53.049).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for H53.049 in the official ICD-10-CM tabular list.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Change history

  • FY2017 — 2016-10-01
    Added to the code set
    Amblyopia suspect, unspecified eye
    FY2017 changes

Verify Before Coding

  • Billable — reportable as written.

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

Contextual Map

Every relationship of H53.049 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]
  • H53-H54 — Visual disturbances and blindness [Hierarchy]

Clinical classification (CCSR)

  • EYE010 — Blindness and vision defects [CCSR]

Potential MS-DRG

  • 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)”
  • DRG 125 — OTHER DISORDERS OF THE EYE WITHOUT MCC [MS-DRG]: “OTHER DISORDERS OF THE EYE WITHOUT MCC (MDC 02)”

MDC crossing · procedures (1200)

  • 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.”
  • 039S0ZX — Drainage of Right Temporal Artery, Open Approach, Diagnostic [Same-MDC procedure]: “Drainage of Right Temporal Artery, Open Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
  • 039S4ZX — Drainage of Right Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic [Same-MDC procedure]: “Drainage of Right Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
  • 039T0ZX — Drainage of Left Temporal Artery, Open Approach, Diagnostic [Same-MDC procedure]: “Drainage of Left Temporal Artery, Open Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
  • 039T4ZX — Drainage of Left Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic [Same-MDC procedure]: “Drainage of Left Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
  • 03BS0ZX — Excision of Right Temporal Artery, Open Approach, Diagnostic [Same-MDC procedure]: “Excision of Right Temporal Artery, Open Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
  • and 1195 more

Nearest codes (40)

  • H53 — Visual disturbances [Sibling]
  • H53.009 — Unspecified amblyopia, unspecified eye [Sibling]
  • H53.01 — Deprivation amblyopia [Sibling]
  • H53.011 — Deprivation amblyopia, right eye [Sibling]
  • H53.012 — Deprivation amblyopia, left eye [Sibling]
  • H53.013 — Deprivation amblyopia, bilateral [Sibling]
  • H53.019 — Deprivation amblyopia, unspecified eye [Sibling]
  • H53.02 — Refractive amblyopia [Sibling]
  • and 32 more

Change history

  • FY2017 — Added to the code set [Change history]

Relationships & Classification

Clinical classification (AHRQ CCSR):EYE010 — Blindness and vision defects (default).

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

Potential MS-DRG Relationships (FY2026)

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

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.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to H53.049 in its code family, with their registry titles.

  • H53.039 — Strabismic amblyopia, unspecified eye
  • H53.04 — Amblyopia suspect
  • H53.041 — Amblyopia suspect, right eye
  • H53.042 — Amblyopia suspect, left eye
  • H53.043 — Amblyopia suspect, bilateral
  • H53.1 — Subjective visual disturbances
  • H53.10 — Unspecified subjective visual disturbances
  • H53.11 — Day blindness
  • H53.12 — Transient visual loss
  • H53.121 — Transient visual loss, right eye

View all codes in the H53 family