ICD10BillableValid for clinical use

ICD-10 Code H49.10: Fourth [trochlear] nerve palsy, unspecified eye

H49.10 is a billable ICD-10 diagnosis code used to classify Fourth [trochlear] nerve palsy, unspecified eye in medical records and claims. You may see this code in hospital records, discharge summaries, insurance claims, encounter documentation, referrals, or other healthcare billing and coding records. ICD-10 codes are diagnosis classification codes used in healthcare records, reporting, coding workflows, and billing support. This code sits within the broader ICD-10 area for Diseases of the eye and adnexa (H00-H59).

Reviewed by HealthAssure Clinical TeamUpdated 26 May 2026

What is this code?

ICD-10 codes are diagnosis classification codes used in healthcare records, reporting, coding workflows, and billing support. This code sits within the broader ICD-10 area for Diseases of the eye and adnexa (H00-H59).

When is it used?

  • May be used when a clinician documents fourth [trochlear] nerve palsy, unspecified eye in a patient's medical record.
  • May appear in hospital records, claims, referrals, and clinical documentation.
  • This code can be used as a clinically usable diagnosis entry in standardized coding workflows.

What it does not mean

  • A code alone does not explain severity, treatment plan, or outcome.
  • A medical code should not be treated as a substitute for a doctor's diagnosis or advice.

Code hierarchy

chapter
7Diseases of the eye and adnexa (H00-H59)
block
H49-H52Disorders of ocular muscles, binocular movement, accommodation and refraction
category
H49Paralytic strabismus
category
H49.1Fourth [trochlear] nerve palsy
currentH49.1

Where you may see this code

You may see this code in hospital records, discharge summaries, insurance claims, encounter documentation, referrals, or other healthcare billing and coding records.

Related specialists

OphthalmologistENT Specialist

Coverage-related procedures and services

CPT 92083high
VISUAL FIELD EXAMINATION, UNILATERAL OR BILATERAL, WITH INTERPRETATION AND REPORT; EXTENDED EXAMINATION (EG, GOLDMANN VISUAL FIELDS WITH AT LEAST 3 ISOPTERS PLOTTED AND STATIC DETERMINATION WITHIN THE CENTRAL 30 DEG, OR QUANTITATIVE, AUTOMATED THRESHOLD PERIMETRY, OCTOPUS PROGRAM G-1, 32 OR 42, HUMPHREY VISUAL FIELD ANALYZER FULL THRESHOLD PROGRAMS 30-2, 24-2, OR 30/60-2)
Source: CMS coverage guidance
CPT 92082high
VISUAL FIELD EXAMINATION, UNILATERAL OR BILATERAL, WITH INTERPRETATION AND REPORT; INTERMEDIATE EXAMINATION (EG, AT LEAST 2 ISOPTERS ON GOLDMANN PERIMETER, OR SEMIQUANTITATIVE, AUTOMATED SUPRATHRESHOLD SCREENING PROGRAM, HUMPHREY SUPRATHRESHOLD AUTOMATIC DIAGNOSTIC TEST, OCTOPUS PROGRAM 33)
Source: CMS coverage guidance
CPT 92081high
VISUAL FIELD EXAMINATION, UNILATERAL OR BILATERAL, WITH INTERPRETATION AND REPORT; LIMITED EXAMINATION (EG, TANGENT SCREEN, AUTOPLOT, ARC PERIMETER, OR SINGLE STIMULUS LEVEL AUTOMATED TEST, SUCH AS OCTOPUS 3 OR 7 EQUIVALENT)
Source: CMS coverage guidance

Coding guidelines

Common synonyms

Fourth [trochlear] nerve palsy, unspecified eyeFourth [trochlear] nerve palsy

Frequently asked questions

Code details

CodeH49.10
SystemICD10
Display nameFourth [trochlear] nerve palsy, unspecified eye
ChapterDiseases of the eye and adnexa (H00-H59)
BlockDisorders of ocular muscles, binocular movement, accommodation and refraction

Flags

BillableYes
Valid clinical useYes

Source

SourceICD-10
Version2026-annual
Releaseannual
Year2026

About this content

This page is prepared by HealthAssure's clinical team using official coding standards from ICD-10. AI tools assist with drafting explanations, which are then reviewed and verified by healthcare professionals for accuracy. This content is for informational purposes and does not replace professional medical advice. Meet our team.

ICD-10 Code H49.10 for Fourth [trochlear] nerve palsy, unspecified eye | HealthAssure