MCMCB Pro
H35.043

H35.043Retinal micro-aneurysms, unspecified, bilateral

Billable / specific codeICD-10-CMbilateral

H35.043 is a billable, specific ICD-10-CM code for retinal micro-aneurysms, unspecified, bilateral. It is valid for submission on a claim.

Risk adjustment

H35.043 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

H35.043 is named in 24 Medicare coverage policies 24 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
  • A56453Billing and Coding: Cataract Extraction
  • A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
  • A56544Billing and Coding: Cataract Extraction

Related codes at this level

Codes that share H35.04. If H35.043 is not quite right, the correct code is usually one of these.

Questions about H35.043

Is H35.043 a billable ICD-10-CM code?
Yes. H35.043 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does H35.043 sit in the tabular list?
Diseases of the eye and adnexa (H00-H59), in the block Disorders of choroid and retina (H30-H36).
ICD-10-CMFY2026-Apr· effective April 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release — see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.