H34.8190 — Central retinal vein occlusion, unspecified eye, with macular edema
H34.8190 is a billable, specific ICD-10-CM code for central retinal vein occlusion, unspecified eye, with macular edema. It is valid for submission on a claim.
7th character "0" — with macular edema
One of the following 7th characters is to be assigned to codes in subcategory H34.81 to designate the severity of the occlusion:
- 0
- with macular edema
- 1
- with retinal neovascularization
- 2
- stable
Risk adjustment
H34.8190 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 298 Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage0.336 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
H34.8190 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57637Billing and Coding: Visual Field Examination
Related codes at this level
Codes that share H34.819. If H34.8190 is not quite right, the correct code is usually one of these.
Questions about H34.8190
- Is H34.8190 a billable ICD-10-CM code?
- Yes. H34.8190 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H34.8190 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of choroid and retina (H30-H36).