ICD-10 Code H49.3 – Total (external) ophthalmoplegia (2026): Diagnosis, Symptoms & Billing Guide

The ICD-10 code for Total (external) ophthalmoplegia is H49.3.
2026 ICD-10-CM Diagnosis Code H49.3 – Total (external) ophthalmoplegia

What it is

Total external ophthalmoplegia means paralysis or severe weakness of the extraocular muscles, so the eye cannot move normally. The condition affects external eye movement, not the pupil or eyelid alone.

Clinical signs

Clinical features vary; refer to documentation. Typical findings include marked limitation of gaze in all directions and diplopia when movement is attempted. Check whether the record specifies complete external ophthalmoplegia versus a partial form.

When to use this code

Use H49.3 when the provider documents total external ophthalmoplegia, complete ophthalmoplegia, or equivalent wording. It fits cases where the diagnosis is established clinically or by specialist assessment. Do not code it from symptoms alone if the note only says eye movement is limited; Check documentation.

Do not use for

Do not use this code for isolated ptosis, diplopia without ophthalmoplegia, or other cranial nerve palsies unless total external ophthalmoplegia is documented. Do not apply it to nonspecific eye pain or blurred vision.

Coding tip

Verify laterality and whether the provider means total external ophthalmoplegia before assigning H49.3.

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