H30.042
H30.042 — Focal chorioretinal inflammation, macular or paramacular, left eye
Billable / specific codeICD-10-CMleft
H30.042 is a billable, specific ICD-10-CM code for focal chorioretinal inflammation, macular or paramacular, left eye. It is valid for submission on a claim.
Risk adjustment
H30.042 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
H30.042 is named in 20 Medicare coverage policies — 20 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
- A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
- A56551Billing and Coding: Visual Fields Testing
- A56672Billing and Coding: Electroretinography (ERG)
Related codes at this level
Codes that share H30.04. If H30.042 is not quite right, the correct code is usually one of these.
Questions about H30.042
- Is H30.042 a billable ICD-10-CM code?
- Yes. H30.042 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H30.042 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of choroid and retina (H30-H36).