H49

Non-Billable
ChapterH00–H59
Rankcategory
Official Description

Paralytic strabismus

Metadata & Insights
  • •2026 ICD-10-CM Edition - Effective October 1, 2025.
  • •Non-billable category (requires more specific sub-code).
  • •Chapter 7: Diseases of the Eye and Adnexa (H00-H59).

CH7 Parent Instructions

Excludes2(Not included here)
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury (trauma) of eye and orbit (S05.-)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
  • syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)

H49-H52 Parent Instructions

Excludes2(Not included here)
  • nystagmus and other irregular eye movements (H55)

Instructional Notes

Excludes2(Not included here)
  • internal ophthalmoplegia (H52.51-)
  • internuclear ophthalmoplegia (H51.2-)
  • progressive supranuclear ophthalmoplegia (G23.1)

Clinical Hierarchy

CH7Diseases of the eye and adnexa (H00-H59)
H49-H52Disorders of ocular muscles, binocular movement, accommodation and refraction (H49-H52)
H49Paralytic strabismus
H49.0Third [oculomotor] nerve palsy
H49.1Fourth [trochlear] nerve palsy
H49.2Sixth [abducent] nerve palsy
H49.3Total (external) ophthalmoplegia
H49.4Progressive external ophthalmoplegia
H49.8Other paralytic strabismus
H49.9Unspecified paralytic strabismus

Applicable Ancestor Context

The following parent sections contain instructions or notes that apply to H49:

blockH49-H52
Disorders of ocular muscles, binocular movement, accommodation and refraction (H49-H52)
View context instructions
chapterCH7
Diseases of the eye and adnexa (H00-H59)
View context instructions

Alphabetic Index Mentions

These are Diagnosis Index lookup paths that route to H49. Use them as entry terms for search, then confirm final coding instructions in the Tabular List and notes above.

22 raw paths
Kearns-Sayre syndrome1 unique routes
Direct index entry→H49
Ophthalmoplegia4 unique routes
external→H49(3 variants)
progressive→H49
total→H49
Parinaud's→H49
Paralysis, paralytic (complete) (incomplete)4 unique routes
eye muscle (extrinsic)→H49
muscle, muscular NEC
eye (extrinsic)→H49
ocular→H49
rectus muscle (eye)→H49
Paresis1 unique routes
extrinsic muscle, eye→H49
Parinaud's1 unique routes
ophthalmoplegia→H49
Strabismus (congenital) (nonparalytic)11 unique routes
paralytic→H49(11 variants)
abducens nerve→H49
fourth nerve→H49
Kearns-Sayre syndrome→H49
ophthalmoplegia (external)(3 variants)
progressive→H49(2 variants)
with pigmentary retinopathy→H49
total→H49
sixth nerve→H49
specified type NEC→H49
third nerve→H49
trochlear nerve→H49

MS-DRG Classification

2026

No direct MS-DRG triggers identified.

Cross Reference

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