H54.7 ICD-10-CM Code: Unspecified visual loss

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for H54.7 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 H54.7 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for H54.7

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

Before you code H54.7

1. Unspecified does not mean incorrect. When the record gives no greater specificity, H54.7 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).

   ReviewH54.2, H54.3, H54.4, H54.5, H54.6

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

2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with H54.7. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

   See the official tabular notes

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 — H54.7 is appropriate when the documentation goes no further.

   ReviewH54.2, H54.3, H54.4, H54.5, H54.6

2. Does the documentation support a condition named in H54.7’s Excludes1 note?
   Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
   No → Continue.

   ReviewG45.3

3. Is the underlying (etiologic) condition the Code First note names documented?
   Yes → Sequence the underlying condition first, then H54.7.
   No → Continue; do not add an underlying condition the record does not document.

Consider H54.7. 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).

The underlying (etiologic) condition

Named in the Code First note; sequenced before this code when documented (Guidelines I.A.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

• Excludes1 — check before selecting H54.7(1 note)

  Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with H54.7: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

  CompareG45.3

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

• Code First — sequencing check(1 note)

  Coding workflow: Check whether the underlying or etiologic condition the note names is documented. When it is, sequence it before H54.7. Do not add an underlying condition the record does not document.

  See the official tabular notes · Guidelines I.A.13

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.

Indexed Clinical Terms (8)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

• Decrease (d), vision NEC
• Defect, defective, vision NEC
• Diminished, diminution, vision NEC
• Impaired, impairment (function), vision NEC
• Loss (of), vision, visual
• Poor, vision NEC
• Problem (with) (related to), sight
• Vision, visual, defect, defective NEC

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Don’t confuse H54.7 with…

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

The codes most likely to be picked instead of H54.7 — 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.

• G45.3— Excludes1 conflict (Excludes1 — generally not reported together)

  Not coded here — the tabular list excludes this pair for the same encounter.

  Not reported together with this code, except where the two conditions are documented as unrelated.

  What moves you there: Documentation of amaurosis fugax moves the case to G45.3; the two are not reported together unless documented as unrelated.

  Full comparison: H54.7 vs G45.3 →

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

• Principal-diagnosis restriction. The Medicare Code Editor lists this code as unacceptable as a principal diagnosis: it describes a circumstance influencing health status rather than a current illness or injury being treated. It is valid as a secondary diagnosis.

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

Other codes that name H54.7 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Use Additional Code instruction: S04.0 — Injury of optic nerve and pathways (via H54.-).

These codes instruct coders to additionally report this code when it applies.

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):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.

Related Codes

Principal diagnosis restriction (Medicare Code Editor)

Not acceptable as a principal diagnosis on an inpatient claim.

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Blindness and vision defects).

H54.41 — Blindness, right eye, normal vision left eye, H54.413A — Blindness right eye category 3, normal vision left eye, H54.414A — Blindness right eye category 4, normal vision left eye, H54.415A — Blindness right eye category 5, normal vision left eye, H54.42 — Blindness, left eye, normal vision right eye, H54.42A3 — Blindness left eye category 3, normal vision right eye, H54.42A4 — Blindness left eye category 4, normal vision right eye, H54.42A5 — Blindness left eye category 5, normal vision right eye, H54.50 — Low vision, one eye, unspecified eye, H54.51 — Low vision, right eye, normal vision left eye, H54.511A — Low vision right eye category 1, normal vision left eye, H54.512A — Low vision right eye category 2, normal vision left eye, H54.52 — Low vision, left eye, normal vision right eye, H54.52A1 — Low vision left eye category 1, normal vision right eye, H54.52A2 — Low vision left eye category 2, normal vision right eye, H54.60 — Unqualified visual loss, one eye, unspecified, H54.61 — Unqualified visual loss, right eye, normal vision left eye, H54.62 — Unqualified visual loss, left eye, normal vision right eye, H54.8 — Legal blindness, as defined in USA, Z45.31 — Encounter for adjustment and management of implanted visual substitution device, +116 more

Same Index main term, other category

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

H53.40 — Unspecified visual field defects (visual field), H53.41 — Scotoma involving central area (visual field, localized, scotoma), H53.42 — Scotoma of blind spot area (visual field, localized, scotoma, blind spot area), H53.43 — Sector or arcuate defects (visual field, localized, sector), H53.45 — Other localized visual field defect (visual field, localized, specified type NEC), H53.46 — Homonymous bilateral field defects (visual field, bilateral, homonymous), H53.47 — Heteronymous bilateral field defects (visual field, bilateral, heteronymous), H53.48 — Generalized contraction of visual field (visual field, generalized contraction), H53.8 — Other visual disturbances (disorientation), H53.9 — Unspecified visual disturbance (disturbance), H57.9 — Unspecified disorder of eye and adnexa (eye), H74.32 — Partial loss of ear ossicles (ossicles, ear), H90.0 — Conductive hearing loss, bilateral (hearing, conductive, bilateral), H90.1 — Conductive hearing loss, unilateral with unrestricted hearing on the contralateral side (hearing, conductive, unilateral, with, unrestricted hearing on the contralateral side), H90.2 — Conductive hearing loss, unspecified (hearing, conductive), H90.3 — Sensorineural hearing loss, bilateral (hearing, sensorineural NOS, bilateral), H90.4 — Sensorineural hearing loss, unilateral with unrestricted hearing on the contralateral side (hearing, sensorineural NOS, unilateral, with, unrestricted hearing on the contralateral side), H90.5 — Unspecified sensorineural hearing loss (hearing, neural NOS), H90.6 — Mixed conductive and sensorineural hearing loss, bilateral (hearing, mixed conductive and sensorineural hearing loss, bilateral), H90.7 — Mixed conductive and sensorineural hearing loss, unilateral with unrestricted hearing on the contralateral side (hearing, mixed conductive and sensorineural hearing loss, unilateral, with, unrestricted hearing on the contralateral side), +293 more

Contextual Map

Every relationship of H54.7 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.

Run H54.7 with this related code in Claim Check

Hierarchy

• H00-H59 — Chapter 7: Diseases of the Eye and Adnexa (H00-H59) (H00-H59)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H53-H54 — Visual disturbances and blindness[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Referenced by Use Additional Code instructions

• S04.0 — Injury of optic nerve and pathways[Use Additional Code](via H54.-): “code to identify any visual field defect or blindness (H53.4-, H54.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

• EYE010 — Blindness and vision defects[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

Index entries

• Decrease (d), vision NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Defect, defective, vision NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Diminished, diminution, vision NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Impaired, impairment (function), vision NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Loss (of), vision, visual[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Poor, vision NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Problem (with) (related to), sight[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Vision, visual, defect, defective NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (40)

• H54 — Blindness and low vision[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H54.1225 — Low vision right eye category 2, blindness left eye category 5[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H54.2 — Low vision, both eyes[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H54.2X — Low vision, both eyes, different category levels[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H54.2X1 — Low vision, right eye, category 1[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H54.2X11 — Low vision right eye category 1, low vision left eye category 1[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H54.2X12 — Low vision right eye category 1, low vision left eye category 2[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• H54.2X2 — Low vision, right eye, category 2[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

Coding guidelines Official source data

ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section 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 H54.7 in its code family, with their registry titles.

• H54.512 — Low vision, right eye, category 2
• H54.512A — Low vision right eye category 2, normal vision left eye
• H54.52 — Low vision, left eye, normal vision right eye
• H54.52A — Low vision, left eye, category 1-2
• H54.52A1 — Low vision left eye category 1, normal vision right eye
• H54.52A2 — Low vision left eye category 2, normal vision right eye
• H54.6 — Unqualified visual loss, one eye
• H54.60 — Unqualified visual loss, one eye, unspecified
• H54.61 — Unqualified visual loss, right eye, normal vision left eye
• H54.62 — Unqualified visual loss, left eye, normal vision right eye

View all codes in the H54 family