H53.411
H53.411 — Scotoma involving central area, right eye
Billable / specific codeICD-10-CMright
H53.411 is a billable, specific ICD-10-CM code for scotoma involving central area, right eye. It is valid for submission on a claim.
Risk adjustment
H53.411 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
H53.411 is named in 27 Medicare coverage policies — 27 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53057Billing and Coding: Home Health Occupational Therapy
- A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
- A53064Billing and Coding: Outpatient Occupational Therapy
- A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Code history
H53.411 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share H53.41. If H53.411 is not quite right, the correct code is usually one of these.
Questions about H53.411
- Is H53.411 a billable ICD-10-CM code?
- Yes. H53.411 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H53.411 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Visual disturbances and blindness (H53-H54).