H21.56 — Pupillary abnormalities
Is H21.56 billable?
No — H21.56 is a non-billable header code. H21.56 groups more specific codes and cannot be submitted on a claim. A valid ICD-10-CM code must be reported at the highest level of specificity available in its branch. Select one of the 4 billable codes beneath H21.56.
H21.56 at a glance
| Code | H21.56 |
|---|---|
| Description | Pupillary abnormalities |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
How is H21.56 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to H21.56. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Abnormal, abnormality, abnormalities › pupillary
Excludes1 — never code together
The conditions below can never be reported together with H21.56 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- congenital deformity of pupil (Q13.2-)
Inclusion terms
Alternative wording in documentation that is classified to H21.56.
- Deformed pupil
- Ectopic pupil
- Rupture of sphincter, pupil
Excludes1 — never code together — inherited from H21.5
The conditions below can never be reported together with H21.56 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- corectopia (Q13.2)
Excludes2 — not included here — inherited from Chapter 7
The conditions below are not part of H21.56, but a patient may have both at the same time. When documentation supports it, H21.56 and the excluded code may both be reported.
- 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)
Excludes2 — not included here — inherited from H21
The conditions below are not part of H21.56, but a patient may have both at the same time. When documentation supports it, H21.56 and the excluded code may both be reported.
- sympathetic uveitis (H44.1-)
What codes fall under H21.56? (4)
How long has H21.56 existed?
H21.56 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.