H21.56
Non-Billable

Pupillary abnormalities

Non-Billable / Non-Specific Code

What is Pupillary abnormalities?

ICD-10-CM H21.56 is the diagnosis code for Pupillary abnormalities. This code falls under the section "Disorders of sclera, cornea, iris and ciliary body" within Chapter 7 — Diseases of the eye and adnexa (H00-H59). It is a non-billable/non-specific ICD-10-CM code that should not be used for reimbursement. A more specific sub-code is required for billing. Medical coders and healthcare providers use this code to document and classify diagnoses in electronic health records, insurance claims, and clinical databases.

💡 Inclusions
⛔ Excludes1

Coding Guidelines for H21.56

✅ This Code Includes

  • Deformed pupil
  • Ectopic pupil
  • Rupture of sphincter, pupil

⛔ Type 1 Excludes (Never code together)

The following conditions should never be coded at the same time as H21.56. They are mutually exclusive:

  • congenital deformity of pupil (Q13.2-)

ICD-10-CM Code Hierarchy

Understanding where H21.56 sits in the ICD-10-CM classification helps ensure proper coding:

Sub-Codes 4 entries
H21.561Pupillary abnormality, right eyeBillableH21.562Pupillary abnormality, left eyeBillableH21.563Pupillary abnormality, bilateralBillableH21.569Pupillary abnormality, unspecified eyeBillable
Related Codes

Frequently Asked Questions

Is H21.56 a billable ICD-10-CM code?

No, H21.56 is a non-billable/non-specific code. You should use a more specific sub-code for billing and reimbursement.

What does H21.56 mean?

H21.56 is the ICD-10-CM diagnosis code for "Pupillary abnormalities". It is used by healthcare providers to classify and document this condition in medical records and insurance claims.

What is the parent code of H21.56?

The parent code of H21.56 is H21.5 ("Other and unspecified adhesions and disruptions of iris and ciliary body"). H21.56 provides a more specific classification within this category.

What section is H21.56 in?

H21.56 is located in Section H15-H22 — "Disorders of sclera, cornea, iris and ciliary body" within Chapter 7 of the ICD-10-CM Tabular List.

What are the sub-codes of H21.56?

H21.56 has 4 sub-code(s) that provide more specific detail: H21.561, H21.562, H21.563, H21.569.

When should I use H21.56?

Use H21.56 when the patients documented diagnosis matches "Pupillary abnormalities" and the clinical documentation supports this level of specificity. Always verify with the latest ICD-10-CM guidelines and payer requirements.

People Also Ask

What is the ICD-10 code for Pupillary abnormalities?

The ICD-10-CM code for Pupillary abnormalities is H21.56.

Can H21.56 be used for primary diagnosis?

No, H21.56 is non-billable. Use a more specific sub-code for primary diagnosis billing.

What chapter is H21.56 in?

H21.56 is in Chapter 7 of the ICD-10-CM Tabular List.

What conditions are excluded from H21.56?

Type 1 Excludes for H21.56 include: congenital deformity of pupil (Q13.2-).

Is H21.56 valid for 2026?

Yes, H21.56 is a valid ICD-10-CM code for the 2026 fiscal year, subject to official CMS updates.

See Also

← PreviousH21.559Recession of chamber angle, unspecified eyeNext →H21.561Pupillary abnormality, right eye
Code Details
H21.56
Pupillary abnormalities
Non-Billable / Non-Specific Code
7 — Diseases of the eye and adnexa (H00-H59)
H15-H22 — Disorders of sclera, cornea, iris and ciliary body
2026 ICD-10-CM