ICD-10 Code H49.22 – Sixth [abducent] nerve palsy, left eye (2026): Diagnosis, Symptoms & Billing Guide

The ICD-10 code for Sixth [abducent] nerve palsy, left eye is H49.22.
2026 ICD-10-CM Diagnosis Code H49.22 – Sixth [abducent] nerve palsy, left eye

What it is

H49.22 identifies paralysis or weakness of the left sixth cranial nerve, which controls lateral eye movement. This code describes impaired abduction of the left eye, often causing horizontal misalignment.

Clinical signs

Typical findings include inability or reduced ability to move the left eye outward, diplopia, and esotropia on exam. Clinical features vary; refer to documentation.

When to use this code

Use H49.22 when the provider documents sixth nerve palsy affecting only the left eye. It is appropriate for confirmed abducent nerve palsy, whether acute or chronic, when the laterality is specified. If the record only says cranial nerve palsy without eye or side, check documentation.

Do not use for

Do not use this code for unspecified sixth nerve palsy, bilateral involvement, or palsy of another cranial nerve. Do not assign it when the chart does not clearly identify the left eye.

Coding tip

Confirm laterality in the assessment or impression before coding, because H49.22 is side-specific.

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