ICD-10 Code H49.20 – Sixth [abducent] nerve palsy, unspecified eye (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code H49.20 – Sixth [abducent] nerve palsy, unspecified eye
What it is
H49.20 identifies paralysis or weakness of the sixth cranial nerve affecting eye movement, without laterality specified. This nerve controls lateral gaze, so impairment can limit outward movement of the eye.
Clinical signs
Typical findings include horizontal diplopia and reduced abduction of the affected eye. Clinical features vary; refer to documentation if the note does not clearly confirm sixth nerve involvement.
When to use this code
Use this code when the provider documents sixth nerve palsy but does not specify right or left eye. It also fits cases where the chart states abducent nerve palsy or sixth cranial nerve palsy without laterality. If the record identifies a specific eye, code that laterality instead.
Do not use for
Do not use H49.20 when the documentation specifies right or left eye, or when the diagnosis is a different ocular motor nerve palsy. Check documentation if the note only mentions diplopia without confirming sixth nerve palsy.
Coding tip
Assign H49.20 only when laterality is truly unspecified; otherwise, choose the more specific sixth nerve palsy code.