The ICD 10 code for refractive error sits in the H52 family, and presbyopia is H52.4, a flat code with no laterality. Hypermetropia, myopia and astigmatism all split by eye, per the ICD-10-CM Tabular List. Picking between them is transcription rather than judgment, which is why the refractive diagnosis is almost never where the claim actually goes wrong.
What is the presbyopia ICD 10 code?
Presbyopia is coded to H52.4, and that is the entire code. No fifth character, no laterality, per the ICD-10-CM Tabular List. The Alphabetic Index sends the main term Presbyopia straight to H52.4 with no subentries.
Presbyopia is therefore the one refractive diagnosis that cannot be wrong for missing laterality. Every other condition in the family carries a right, left, bilateral or unspecified variant, and unspecified is the one that says nobody read the chart.
Key insight:
Presbyopia is the only condition in H52 with no laterality character to forget, which makes it the only refractive code that cannot come back short.
What is the myopia ICD 10 code, and what does its Excludes1 note block?
Myopia is coded to H52.1, subdivided as H52.10 unspecified eye, H52.11 right eye, H52.12 left eye and H52.13 bilateral.
H52.1 carries an Excludes1 note for degenerative myopia, H44.2-, per the ICD-10-CM Tabular List, and Excludes1 means the two are never reported together. The Alphabetic Index routes myopia qualified as degenerative, malignant, pernicious or progressive high to H44.2- instead, where the subentries cover choroidal neovascularization, macular hole and retinal detachment.
Key insight:
The word degenerative moves myopia out of the refractive chapter and onto a retinal disease, and it moves the reason for the visit with it.
What are the hypermetropia and astigmatism ICD 10 codes?
Hypermetropia is coded to H52.0, subdivided as H52.00 unspecified eye, H52.01 right eye, H52.02 left eye and H52.03 bilateral. Hyperopia, the word most charts use, indexes to the same codes.
Astigmatism is coded to H52.2 and takes six characters, because it splits by type before it splits by eye. The types are H52.20 unspecified, H52.21 irregular and H52.22 regular, then 1 right, 2 left, 3 bilateral and 9 unspecified. Regular astigmatism in the right eye is H52.221.
Key insight:
Astigmatism is the one refractive code where the chart has to say regular or irregular before the code can be built, and nobody at the front desk can supply that.
Does the ICD 10 code for refractive error need laterality?
The H52 family in full, from the ICD-10-CM Tabular List.
| Code | Condition | Laterality |
|---|---|---|
| H52.0- | Hypermetropia | Yes, fifth character |
| H52.1- | Myopia | Yes, fifth character |
| H52.2-- | Astigmatism | Yes, sixth character |
| H52.31 | Anisometropia | No |
| H52.32 | Aniseikonia | No |
| H52.4 | Presbyopia | No |
| H52.5- | Disorders of accommodation | Yes, sixth character |
| H52.6 | Other disorders of refraction | No |
| H52.7 | Unspecified disorder of refraction | No |
Anisometropia and aniseikonia describe a difference between the eyes, so a one eye code would contradict the diagnosis. H52.4 is built the same way.
Key insight:
Laterality in H52 tracks whether a condition can exist in one eye at all, so a guess produces a code that argues with its own description.
How does an H52 code decide which plan the visit belongs to?
An H52 code keeps a visit in the vision lane. A refractive error is the finding a routine exam exists to produce, and it is the diagnosis CPT 92015 is billed against. A medical diagnosis on the same claim moves the visit somewhere else entirely, which is the fork set out in how medical and vision coverage divide a visit.
Sequence matters when the patient booked because of a symptom. Per the ICD-10-CM Official Guidelines for Coding and Reporting, section I.B.4, a symptom code holds only until a related definitive diagnosis is established by the provider, and section I.B.5 says a symptom routinely associated with that diagnosis is not assigned as an additional code. A visit that opened on the code for blurry vision and closed on uncorrected refractive error therefore resolves to H52 alone.
On a routine exam an H52 code sits under Z01.01, encounter for examination of eyes and vision with abnormal findings, which carries a use additional code instruction in the Tabular List. The exam codes that pair with it are in the guide to CPT codes for eye exams.
Key insight:
An H52 code does not choose the payer, it reports a choice the reason for the visit already made, which is why the routing call belongs at check in.
Did the myopia ICD 10 code or any of H52 change on 1 October 2026?
No. The H52 family is identical in the FY2026 code set, which runs through 30 September 2026, and the FY2027 code set, which takes effect on 1 October 2026. Both were checked against the CMS code descriptions file for each year. Every code in the table, the Excludes1 note under H52.1 and the absence of laterality on H52.4 carry forward unchanged.
Key insight:
H52 is a stable corner of the eye chapter, so a refractive denial on 2 October is a routing or laterality problem, never a code update anyone missed.
Check both plans before the exam, not after the denial
GIMBL checks eligibility on the vision plan and the medical plan at intake, decides which one the visit belongs to, and builds the claim before the exam.
Create your GIMBL account and set the lane before the exam.
Frequently asked questions on refractive error ICD 10 codes
What is the ICD 10 code for presbyopia?
Presbyopia is H52.4. It is a flat code with no fifth or sixth character and no laterality, so H52.4 is reported on its own. The ICD-10-CM Alphabetic Index lists Presbyopia with no subentries, and the code is unchanged in both the FY2026 and FY2027 code sets.
What is the ICD 10 code for myopia?
Myopia is H52.1, reported as H52.10 unspecified eye, H52.11 right eye, H52.12 left eye or H52.13 bilateral. H52.1 carries an Excludes1 note for degenerative myopia, H44.2-, so degenerative, malignant, pernicious and progressive high myopia are coded to H44.2- and never to H52.1.
What is the ICD 10 code for astigmatism?
Astigmatism is H52.2 and needs six characters. Unspecified astigmatism is H52.20-, irregular is H52.21- and regular is H52.22-, each closing with 1 for right eye, 2 for left eye, 3 for bilateral and 9 for unspecified eye. Regular astigmatism in the right eye is H52.221.
What is the ICD 10 code for hypermetropia or hyperopia?
Hypermetropia is H52.0, reported as H52.00 unspecified eye, H52.01 right eye, H52.02 left eye or H52.03 bilateral. The ICD-10-CM term is hypermetropia. Hyperopia is the word most charts use and it indexes to the same codes.
Is presbyopia coded with laterality?
No. H52.4 carries no laterality character in the ICD-10-CM Tabular List. Hypermetropia, myopia, astigmatism and the disorders of accommodation in H52.5 all require laterality. Anisometropia, aniseikonia and the unspecified refraction codes do not.
What is the ICD 10 code for unspecified refractive error?
H52.7, unspecified disorder of refraction, with H52.6 available for other disorders of refraction that are documented but not classified elsewhere in the family. Both are flat codes with no laterality.