H31.013
H31.013 — Macula scars of posterior pole (postinflammatory) (post-traumatic), bilateral
Billable / specific codeICD-10-CMbilateral
H31.013 is a billable, specific ICD-10-CM code for macula scars of posterior pole (postinflammatory) (post-traumatic), bilateral. It is valid for submission on a claim.
Risk adjustment
H31.013 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
H31.013 is named in 12 Medicare coverage policies — 12 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)
- A56672Billing and Coding: Electroretinography (ERG)
- A56726Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
Related codes at this level
Codes that share H31.01. If H31.013 is not quite right, the correct code is usually one of these.
Questions about H31.013
- Is H31.013 a billable ICD-10-CM code?
- Yes. H31.013 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H31.013 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of choroid and retina (H30-H36).