H47.519 — Disorders of visual pathways in (due to) inflammatory disorders, unspecified side
Is H47.519 billable?
Yes, but H47.519 will trip a Medicare edit. H47.519 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists H47.519 under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.
H47.519 at a glance
| Code | H47.519 |
|---|---|
| Description | Disorders of visual pathways in (due to) inflammatory disorders, unspecified side |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to H47.519?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name H47.519 directly.
A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.
Which MS-DRGs does H47.519 group to?
H47.519 sits in MDC 01 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 091Other Disorders of Nervous System with MCCmedical
- 092Other Disorders of Nervous System with CCmedical
- 093Other Disorders of Nervous System without CC/MCCmedical
As a secondary diagnosis, H47.519 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is H47.519 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under H47.51, the nearest indexed parent of H47.519. Use them to find the family, then select the specific code.
- Disorder › visual › pathway › due to › inflammatory disorder (of)
Excludes2 — not included here — inherited from Chapter 7
The conditions below are not part of H47.519, but a patient may have both at the same time. When documentation supports it, H47.519 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)
Code also — inherited from H47.5
Two codes may be needed to describe the condition fully. Whether H47.519 is sequenced first depends on the reason for the encounter.
- underlying condition
How long has H47.519 existed?
H47.519 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.