ICD-10 Code H49.03 – Third [oculomotor] nerve palsy, bilateral (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code H49.03 – Third [oculomotor] nerve palsy, bilateral
What it is
H49.03 identifies paralysis or weakness of both third cranial nerves. This nerve helps control eye movement, eyelid position, and pupil response.
Clinical signs
Typical findings include bilateral eye movement limitation, ptosis, and possible pupil abnormalities. Clinical features vary; refer to documentation.
When to use this code
Use this code when the provider documents bilateral oculomotor nerve palsy, bilateral third nerve paresis, or equivalent wording. It fits confirmed neurologic or ophthalmic diagnoses affecting both sides. If the note only mentions diplopia or eye pain without nerve palsy, check documentation.
Do not use for
Do not use H49.03 for isolated ptosis, nonspecific strabismus, or a unilateral third nerve palsy. Also avoid it when the record does not clearly identify bilateral oculomotor nerve involvement.
Coding tip
Look for explicit documentation of bilateral third nerve palsy before assigning H49.03.