Is H33.109 a billable ICD-10-CM code?

Yes. H33.109 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does H33.109 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 H33.109?

H33.109 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 H33.109 (H33.1, H33) and apply to it just the same.

H33.109

H33.109 — Unspecified retinoschisis, unspecified eye

Billable / specific codeICD-10-CMunspecified

H33.109 is a billable, specific ICD-10-CM code for unspecified retinoschisis, unspecified eye. It is valid for submission on a claim.

Excludes1 inherited from the categories above H33.109

These are not written on H33.109, but they bind it: a note on a category applies to every code beneath it. Billing H33.109 with anything listed here is a denial.

Written on H33.1 — Retinoschisis and retinal cysts

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

Written on H33 — Retinal detachments and breaks

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

Risk adjustment

H33.109 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

H33.109 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
A57637Billing and Coding: Visual Field Examination

Code history

H33.109 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share H33.10. If H33.109 is not quite right, the correct code is usually one of these.

Questions about H33.109

Is H33.109 a billable ICD-10-CM code?: Yes. H33.109 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does H33.109 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 H33.109?: H33.109 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 H33.109 (H33.1, H33) and apply to it just the same.