H54.1213

Low vision right eye category 1, blindness left eye category 3

Billable code

This code does not map to a risk-adjusting HCC in the loaded models.

Coding notes

Excludes 1 never coded together · Excludes 2 may co-exist

Inherited from H54.1Blindness, one eye, low vision other eye

Synonyms

Visual impairment categories 3, 4, 5 in one eye, with categories 1 or 2 in the other eye.

Inherited from H54Blindness and low vision

Excludes 1

amaurosis fugax (G45.3)

Code first

any associated underlying cause of the blindness

Note

For definition of visual impairment categories see table below

Inherited from chapter 7Diseases of the eye and adnexa

Excludes 2

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)

Note

Use an external cause code following the code for the eye condition, if applicable, to identify the cause of the eye condition

Official Guidelines for H54.1213

FY 2026 ›

I.C.7Chapter-specific guidanceChapter 7: Diseases of the Eye and Adnexa (H00-H59)

Subsections

Sections that reference H54.1213

I.C.7.bBlindness
If “blindness” or “low vision” of both eyes is documented but the visual impairment category is not documented, assign code H54.3, Unqualified visual loss, both eyes. …

Sections whose FY 2026 text names H54.1213, its H54 category, or a range containing it — the chapter guidance above is the authoritative source.