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ICD-10-CM 2027 diagnosis code

H53.042Amblyopia suspect, left eye

✓ Billable / specific

H53.042 is a valid, billable ICD-10-CM code for amblyopia suspect, left eye. It can be reported on claims for dates of service from October 1, 2026 – September 30, 2027.

Code last changed in FY2017 (effective October 1, 2016). Source: official FY2027 ICD-10-CM release from CDC/NCHS and CMS. Page updated September 29, 2026. About our data

About H53.042

H53.042 is the ICD-10-CM diagnosis code for amblyopia suspect, left eye. It belongs to category H53 (visual disturbances), block H53-H54 (visual disturbances and blindness) and chapter 7 (diseases of the eye and adnexa). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Within H53.04 (amblyopia suspect), H53.042 is specifically for amblyopia suspect, left eye. Related codes cover right eye (H53.041), bilateral (H53.043) and unspecified eye (H53.049).

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

In MS-DRG v44.0, it is part of the grouping logic for DRG 124 (Other Disorders of the Eye with MCC or Thrombolytic Agent, relative weight 1.2471) and DRG 125 (Other Disorders of the Eye without MCC, relative weight 0.7702), in MDC 02 (Diseases and Disorders of the Eye), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It was added in FY2017, effective October 1, 2016.

Before ICD-10, this condition was coded in ICD-9-CM as 368.8 (other specified visual disturbances).

Notes that apply from higher levels

Instructions written at a parent level also apply to H53.042.

› From H53.0 Amblyopia ex anopsia
Excludes1
  • amblyopia due to vitamin A deficiency (E50.5)

Broader instructions also apply from Chapter 7: Diseases of the eye and adnexa.

MS-DRG v44.0 grouping

All DRGs →

Inpatient MS-DRGs this diagnosis can group to, as the principal or a secondary diagnosis, depending on the rest of the claim.

ICD-9-CM equivalent

Converter →
  • 368.8Other specified visual disturbancesapproximate

From the CMS 2018 General Equivalence Mappings (GEMs), the final GEMs release.

Code history

  1. 2016
  2. 2017
  3. 2018
  4. 2019
  5. 2020
  6. 2021
  7. 2022
  8. 2023
  9. 2024
  10. 2025
  11. 2026
  12. 2027
  • FY2017 (effective 10/1/2016): Added
  • No changes since FY2017.

Common questions about H53.042

Is H53.042 billable?

Yes. H53.042 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).

Can H53.042 be used as a principal diagnosis?

Yes. The Medicare Code Editor doesn't restrict H53.042 as a principal diagnosis.

Is H53.042 a CC or MCC?

No. H53.042 is neither a CC nor an MCC under MS-DRG v44.0.

What DRG does H53.042 group to?

H53.042 is used in the MS-DRG v44.0 logic for MS-DRG 124 (Other Disorders of the Eye with MCC or Thrombolytic Agent) and MS-DRG 125 (Other Disorders of the Eye without MCC). Which one applies depends on whether it is the principal diagnosis and on the rest of the claim.

What is the ICD-9 code for H53.042?

The CMS General Equivalence Mappings map H53.042 to ICD-9-CM 368.8.