Is H33.1 a billable ICD-10-CM code?

No. H33.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does H33.1 sit in the tabular list?

Diseases of the eye and adnexa (H00-H59), in the block Disorders of choroid and retina (H30-H36).

What cannot be coded together with H33.1?

H33.1 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above H33.1 (H33) and apply to it just the same.

H33.1

H33.1 — Retinoschisis and retinal cysts

Non-billable headerICD-10-CM

H33.1 is a non-billable header ICD-10-CM code for retinoschisis and retinal cysts. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

congenital retinoschisis (Q14.1)
microcystoid degeneration of retina (H35.42-)

Excludes1 inherited from the categories above H33.1

These are not written on H33.1, but they bind it: a note on a category applies to every code beneath it. Billing H33.1 with anything listed here is a denial.

Written on H33 — Retinal detachments and breaks

detachment of retinal pigment epithelium (H35.72-, H35.73-)

Risk adjustment

H33.1 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.

Code history

H33.1 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead H33.1

4 child codes. Green means billable.

Related codes at this level

Codes that share H33. If H33.1 is not quite right, the correct code is usually one of these.

Questions about H33.1

Is H33.1 a billable ICD-10-CM code?: No. H33.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does H33.1 sit in the tabular list?: Diseases of the eye and adnexa (H00-H59), in the block Disorders of choroid and retina (H30-H36).
What cannot be coded together with H33.1?: H33.1 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above H33.1 (H33) and apply to it just the same.