ICD-10 Code H52.513 – Internal ophthalmoplegia (complete) (total), bilateral (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code H52.513 – Internal ophthalmoplegia (complete) (total), bilateral
What it is
This code identifies complete bilateral internal ophthalmoplegia, meaning both eyes have loss of normal pupillary function. It reflects paralysis of the iris sphincter and ciliary muscle, affecting pupil response and accommodation.
Clinical signs
Typical findings include bilaterally fixed or poorly reactive pupils and impaired near focusing. Clinical features vary; refer to documentation for the cause, onset, and whether the condition is complete or partial.
When to use this code
Use this code when the record clearly documents complete internal ophthalmoplegia in both eyes. It may appear in neurologic, toxic, traumatic, or postoperative contexts, but you should code only when bilateral involvement is stated.
If the note describes pupil abnormalities without confirming internal ophthalmoplegia, check documentation. Do not assume laterality or completeness from nonspecific terms such as anisocoria or mydriasis.
Do not use for
Do not use this code for unilateral involvement, partial internal ophthalmoplegia, or isolated pupil dilation without documented paralysis. Check documentation if the record is unclear.
Coding tip
Verify both laterality and completeness in the provider note before assigning H52.513.