DxCodebookFY2027 · Oct 1, 2026 – Sep 30, 2027

Category · FY2027

H49 Paralytic strabismus

  • Header · not billable

H49 is not billable. The category heads 29 billable codes in FY2027, grouped under 7 subdivisions.

Index → code

  • Kearns-Sayre syndrome → H49.81-
  • Ophthalmoplegiaexternal → H49.88-
  • OphthalmoplegiaParinaud's → H49.88-

Where it sits

  1. Chapter 7 Diseases of the eye and adnexa (H00-H59)
  2. H49-H52 Disorders of ocular muscles, binocular movement, accommodation and refraction (H49-H52)
  3. H49 Paralytic strabismus
Billable codes
29
Subdivisions
7
CC / MCC codes
4 / 0
HCC V28 codes
0
New FY2027
0
Index entries
22

Codes in H49

  1. H49.0
    Third [oculomotor] nerve palsy
    Header
  2. H49.00
    Third [oculomotor] nerve palsy, unspecified eye
    Billable
  3. H49.01
    Third [oculomotor] nerve palsy, right eye
    Billable
  4. H49.02
    Third [oculomotor] nerve palsy, left eye
    Billable
  5. H49.03
    Third [oculomotor] nerve palsy, bilateral
    Billable
  6. H49.1
    Fourth [trochlear] nerve palsy
    Header
  7. H49.10
    Fourth [trochlear] nerve palsy, unspecified eye
    Billable
  8. H49.11
    Fourth [trochlear] nerve palsy, right eye
    Billable
  9. H49.12
    Fourth [trochlear] nerve palsy, left eye
    Billable
  10. H49.13
    Fourth [trochlear] nerve palsy, bilateral
    Billable
  11. H49.2
    Sixth [abducent] nerve palsy
    Header
  12. H49.20
    Sixth [abducent] nerve palsy, unspecified eye
    Billable
  13. H49.21
    Sixth [abducent] nerve palsy, right eye
    Billable
  14. H49.22
    Sixth [abducent] nerve palsy, left eye
    Billable
  15. H49.23
    Sixth [abducent] nerve palsy, bilateral
    Billable
  16. H49.3
    Total (external) ophthalmoplegia
    Header
  17. H49.30
    Total (external) ophthalmoplegia, unspecified eye
    Billable
  18. H49.31
    Total (external) ophthalmoplegia, right eye
    Billable
  19. H49.32
    Total (external) ophthalmoplegia, left eye
    Billable
  20. H49.33
    Total (external) ophthalmoplegia, bilateral
    Billable
  21. H49.4
    Progressive external ophthalmoplegia
    Header
    Excludes1 1

    Excludes1

    • Kearns-Sayre syndrome (H49.81-) H49.81
  22. H49.40
    Progressive external ophthalmoplegia, unspecified eye
    Billable
  23. H49.41
    Progressive external ophthalmoplegia, right eye
    Billable
  24. H49.42
    Progressive external ophthalmoplegia, left eye
    Billable
  25. H49.43
    Progressive external ophthalmoplegia, bilateral
    Billable
  26. H49.8
    Other paralytic strabismus
    Header
  27. H49.81
    Kearns-Sayre syndrome
    Header
    Inclusion terms 1, Code also 2

    Inclusion terms

    • Progressive external ophthalmoplegia with pigmentary retinopathy

    Code also

    • , if applicable, other manifestations, such as:
    • heart block (I45.9) I45.9
  28. H49.811
    Kearns-Sayre syndrome, right eye
    BillableCC
  29. H49.812
    Kearns-Sayre syndrome, left eye
    BillableCC
  30. H49.813
    Kearns-Sayre syndrome, bilateral
    BillableCC
  31. H49.819
    Kearns-Sayre syndrome, unspecified eye
    BillableCC
  32. H49.88
    Other paralytic strabismus
    Header
    Inclusion terms 1

    Inclusion terms

    • External ophthalmoplegia NOS
  33. H49.881
    Other paralytic strabismus, right eye
    Billable
  34. H49.882
    Other paralytic strabismus, left eye
    Billable
  35. H49.883
    Other paralytic strabismus, bilateral
    Billable
  36. H49.889
    Other paralytic strabismus, unspecified eye
    Billable
  37. H49.9
    Unspecified paralytic strabismus
    Billable

CC/MCC: as a secondary diagnosis, unless the principal diagnosis is on the code’s PDX exclusion list (MS-DRG v44 Appendix C; list on the code card).

Sources of each column.

Instructions

At H49

Excludes2

  • internal ophthalmoplegia (H52.51-) H52.51
  • internuclear ophthalmoplegia (H51.2-) H51.2
  • progressive supranuclear ophthalmoplegia (G23.1) G23.1

Notes that also apply

Block H49-H52 instructions (Excludes2 1): printed on the block page.

Chapter 7 instructions (Notes 1, Excludes2 11): printed on the chapter 7 page.

Index entries

  • Kearns-Sayre syndrome → H49.81-
  • Ophthalmoplegiaexternal → H49.88-
  • OphthalmoplegiaParinaud's → H49.88-
  • Parinaud'sophthalmoplegia → H49.88-
  • Paralysis, paralytic (complete) (incomplete)eye muscle (extrinsic) → H49.9
  • Paralysis, paralytic (complete) (incomplete)ocular → H49.9
  • Paralysis, paralytic (complete) (incomplete)rectus muscle (eye) → H49.9
  • Paresisextrinsic muscle, eye → H49.9
  • Strabismus (congenital) (nonparalytic)paralytic → H49.9
  • Strabismus (congenital) (nonparalytic)paralyticthird nerve → H49.0-
  • Strabismus (congenital) (nonparalytic)paralyticfourth nerve → H49.1-
  • Strabismus (congenital) (nonparalytic)paralytictrochlear nerve → H49.1-
  • Strabismus (congenital) (nonparalytic)paralyticabducens nerve → H49.2-
  • Strabismus (congenital) (nonparalytic)paralyticsixth nerve → H49.2-
  • Ophthalmoplegiaexternaltotal → H49.3-
  • Ophthalmoplegiaexternalprogressive → H49.4-
  • Strabismus (congenital) (nonparalytic)paralyticKearns-Sayre syndrome → H49.81-
  • Strabismus (congenital) (nonparalytic)paralyticspecified type NEC → H49.88-
  • Paralysis, paralytic (complete) (incomplete)muscle, muscular NECeye (extrinsic) → H49.9
  • Strabismus (congenital) (nonparalytic)paralyticophthalmoplegia (external)total → H49.3-
  • Strabismus (congenital) (nonparalytic)paralyticophthalmoplegia (external)progressive → H49.4-
  • Strabismus (congenital) (nonparalytic)paralyticophthalmoplegia (external)progressivewith pigmentary retinopathy → H49.81-

NCHS Alphabetic Index. Index first, then the Tabular List.

Hierarchy