H34.8311 — Tributary (branch) retinal vein occlusion, right eye, with retinal neovascularization
H34.8311 is a billable, specific ICD-10-CM code for tributary (branch) retinal vein occlusion, right eye, with retinal neovascularization. It is valid for submission on a claim.
7th character "1" — with retinal neovascularization
One of the following 7th characters is to be assigned to codes in subcategory H34.83 to designate the severity of the occlusion:
- 0
- with macular edema
- 1
- with retinal neovascularization
- 2
- stable
Risk adjustment
H34.8311 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
H34.8311 is named in 36 Medicare coverage policies — 36 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52370Billing and Coding: Bevacizumab and biosimilars
- A52451Billing and Coding: Ranibizumab and biosimilars, Aflibercept, Aflibercept HD, Brolucizumab-dbll, Faricimab-svoa, PAVBLU™aflibercept-ayyh, AHZANTIVE®aflibercept-abzv. ENZEEVU™aflibercept-mrbb, OPUVIZ™aflibercept-yszy and YESAFILI™ aflibercept-jbvf
- A52451Billing and Coding: Ranibizumab and biosimilars, Aflibercept, Aflibercept HD, Brolucizumab-dbll, Faricimab-svoa, PAVBLU™aflibercept-ayyh, AHZANTIVE®aflibercept-abzv. ENZEEVU™aflibercept-mrbb, OPUVIZ™aflibercept-yszy and YESAFILI™ aflibercept-jbvf
- A52451Billing and Coding: Ranibizumab and biosimilars, Aflibercept, Aflibercept HD, Brolucizumab-dbll, Faricimab-svoa, PAVBLU™aflibercept-ayyh, AHZANTIVE®aflibercept-abzv. ENZEEVU™aflibercept-mrbb, OPUVIZ™aflibercept-yszy and YESAFILI™ aflibercept-jbvf
Related codes at this level
Codes that share H34.831. If H34.8311 is not quite right, the correct code is usually one of these.
Questions about H34.8311
- Is H34.8311 a billable ICD-10-CM code?
- Yes. H34.8311 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H34.8311 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of choroid and retina (H30-H36).