H35.031
H35.031 — Hypertensive retinopathy, right eye
Billable / specific codeICD-10-CMright
H35.031 is a billable, specific ICD-10-CM code for hypertensive retinopathy, right eye. It is valid for submission on a claim.
Risk adjustment
H35.031 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
H35.031 is named in 21 Medicare coverage policies — 21 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
- A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
- A56550Billing and Coding: Panretinal (Scatter) Laser Photocoagulation
- A56551Billing and Coding: Visual Fields Testing
Related codes at this level
Codes that share H35.03. If H35.031 is not quite right, the correct code is usually one of these.
Questions about H35.031
- Is H35.031 a billable ICD-10-CM code?
- Yes. H35.031 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H35.031 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of choroid and retina (H30-H36).