ICD-10 Code H05.263 – Pulsating exophthalmos, bilateral (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code H05.263 – Pulsating exophthalmos, bilateral
What it is
Pulsating exophthalmos, bilateral describes forward displacement of both eyes with visible or palpable pulsation. It usually reflects transmission of vascular pulsation to the orbits; check documentation for the underlying cause.
Clinical signs
Findings may include bilateral proptosis, rhythmic eye movement, or pulsation synchronized with the heartbeat. Clinical features vary; refer to documentation, especially when imaging or specialist notes identify a vascular abnormality.
When to use this code
Use this code when the provider documents bilateral pulsating exophthalmos or equivalent wording such as bilateral pulsatile proptosis. It is appropriate when the diagnosis is clearly established in the record, including ophthalmology or radiology documentation.
Code the bilateral condition only when both eyes are involved. If the note describes unilateral pulsation or an unspecified orbital disorder, choose the more accurate documented diagnosis instead.
Do not use for
Do not use this code for nonpulsatile exophthalmos, isolated eyelid swelling, or generic orbital mass without pulsation. Check documentation if the record does not clearly state bilateral involvement.
Coding tip
Confirm the laterality and the word “pulsating” in the provider’s diagnosis before assigning H05.263.