ICD-10 Code H49.2 – Sixth [abducent] nerve palsy (2026): Diagnosis, Symptoms & Billing Guide

The ICD-10 code for Sixth [abducent] nerve palsy is H49.2.
2026 ICD-10-CM Diagnosis Code H49.2 – Sixth [abducent] nerve palsy

What it is

H49.2 identifies paralysis or weakness of the sixth cranial nerve, which controls the lateral rectus muscle. This code describes impaired eye abduction, often causing horizontal misalignment.

Clinical signs

Typical findings include limited outward movement of the affected eye and horizontal diplopia, especially when looking toward the side of the palsy. Clinical features vary; refer to documentation.

When to use this code

Use H49.2 when the record clearly documents sixth nerve palsy, abducent nerve palsy, or sixth cranial nerve paralysis. Apply it for confirmed neurologic or ophthalmologic diagnoses, whether acute or chronic. If the note only says diplopia without nerve involvement, check documentation.

Do not use for

Do not use this code for general eye movement complaints, unspecified cranial nerve disorders, or diplopia without documented sixth nerve involvement. Check documentation when the cause is not stated.

Coding tip

Confirm the provider names the sixth cranial nerve or abducent nerve before assigning H49.2.

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