H53.042 — Amblyopia suspect, left eye
Is H53.042 billable?
Yes — H53.042 is billable for FY2027. H53.042 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. H53.042 may be submitted for encounters from October 1, 2026 through September 30, 2027.
H53.042 at a glance
| Code | H53.042 |
|---|---|
| Description | Amblyopia suspect, left eye |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does H53.042 group to?
H53.042 sits in MDC 02 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 124Other Disorders of the Eye with MCC or Thrombolytic Agentmedical
- 125Other Disorders of the Eye without MCCmedical
How is H53.042 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under H53.04, the nearest indexed parent of H53.042. Use them to find the family, then select the specific code.
- Amblyopia › suspect (congenital) (ex anopsia) (partial) (suppression)
Excludes1 — never code together — inherited from H53.0
The conditions below can never be reported together with H53.042 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- amblyopia due to vitamin A deficiency (E50.5)
Excludes2 — not included here — inherited from Chapter 7
The conditions below are not part of H53.042, but a patient may have both at the same time. When documentation supports it, H53.042 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)
How long has H53.042 existed?
H53.042 first appears in FY2018 (FY2017 is not available, so it may have appeared then).
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.