H31.012

H31.012: Macula scars of posterior pole (postinflammatory) (post-traumatic), left eye

Billable / specific codeICD-10-CMleft

H31.012 is a billable, specific ICD-10-CM code for macula scars of posterior pole (postinflammatory) (post-traumatic), left eye. It is valid for submission on a claim.

Check H31.012 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above H31.012

A category’s note binds every code beneath it.

Written on H31.01: Macula scars of posterior pole (postinflammatory) (post-traumatic)

postprocedural choriorentinal scar (H59.81-)

Excludes2 inherited from the categories above H31.012

Not part of this code, but both may be coded when both are present.

Written on H31.0: Chorioretinal scars

postsurgical chorioretinal scars (H59.81-)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

H31.012 is named in 12 Medicare coverage policies: 12 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
A56672Billing and Coding: Electroretinography (ERG)
A56726Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)

Code history

Unchanged in every release from FY2024 to FY2027.