H35.0 — Background retinopathy and retinal vascular changes
H35.0 is a non-billable header ICD-10-CM code for background retinopathy and retinal vascular changes. It cannot be billed on its own: choose one of the more specific child codes below.
Code also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
- any associated hypertension (I10)
Excludes2 inherited from the categories above H35.0
Also inherited, and the opposite of Excludes1: these conditions are not part of H35.0, but a patient can have both, so you may code both.
Other codes that can never be billed with H35.0
These codes carry an Excludes1 note pointing at H35.0. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading H35.0 alone.
- H36Retinal disorders in diseases classified elsewhere
Risk adjustment
H35.0 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
H35.0 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 H35.0
9 child codes. Green means billable.
- H35.00Unspecified background retinopathy
- H35.01Changes in retinal vascular appearance
- H35.02Exudative retinopathy
- H35.03Hypertensive retinopathy
- H35.04Retinal micro-aneurysms, unspecified
- H35.05Retinal neovascularization, unspecified
- H35.06Retinal vasculitis
- H35.07Retinal telangiectasis
- H35.09Other intraretinal microvascular abnormalities
Related codes at this level
Codes that share H35. If H35.0 is not quite right, the correct code is usually one of these.
- H35.1Retinopathy of prematurity
- H35.2Other non-diabetic proliferative retinopathy
- H35.3Degeneration of macula and posterior pole
- H35.4Peripheral retinal degeneration
- H35.5Hereditary retinal dystrophy
- H35.6Retinal hemorrhage
- H35.7Separation of retinal layers
- H35.8Other specified retinal disorders
- H35.9Unspecified retinal disorder
Questions about H35.0
- Is H35.0 a billable ICD-10-CM code?
- No. H35.0 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does H35.0 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of choroid and retina (H30-H36).