Excludes1 pair
H54.7 vs H54.8
H54.7 and H54.8 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.
The official note, declared on H54.8
legal blindness with specification of impairment level (H54.0-H54.7)
H54.7
Unspecified visual loss
BillableUnspecified
- Chapter 7
- Diseases of the eye and adnexa
- Section
- H53-H54
Use when the record says
- Visual impairment category 9 NOS
Indexed under
- Decrease › vision NEC
- Defect, defective › vision NEC
- Diminished, diminution › vision NEC
- Impaired, impairment › vision NEC
- Loss › vision, visual
H54.8
Legal blindness, as defined in USA
Billable
- Chapter 7
- Diseases of the eye and adnexa
- Section
- H53-H54
Use when the record says
- Blindness NOS according to USA definition
Indexed under
- Blindness › legal (both eyes) (USA definition)
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027