ICD-10 Code H57.053 – Tonic pupil, bilateral (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code H57.053 – Tonic pupil, bilateral
What it is
Tonic pupil, bilateral refers to abnormally slow or weak pupillary constriction in both eyes. It usually reflects impaired parasympathetic control of the pupils.
Clinical signs
You may see large pupils that react sluggishly to light and constrict better with near focus. Clinical features vary; refer to documentation.
When to use this code
Use this code when the clinician documents bilateral tonic pupil or bilateral Adie-type pupil. It applies when the diagnosis is confirmed or clearly stated in the record. Check documentation if the note only mentions anisocoria, mydriasis, or abnormal pupil response without specifying tonic pupil.
Do not use for
Do not use this code for unilateral tonic pupil, nonspecific pupillary abnormality, or pupil changes caused by trauma, drugs, or neurologic disease unless bilateral tonic pupil is documented. Check documentation.
Coding tip
Code only when bilateral involvement is explicitly documented; laterality matters for this diagnosis.