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.
Check H34.8311 with the rest of the claim: free scrubber7th 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
H34.8311 is named in 33 Medicare coverage policies: 33 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52370Billing and Coding: Bevacizumab and biosimilars
- A52451Billing and Coding: Ranibizumab, Aflibercept and biosimilars
- A53008Billing and Coding: Intraocular Bevacizumab
- A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Code history
Unchanged in every release from FY2024 to FY2027.