H35.1
H35.1 — Retinopathy of prematurity
Non-billable headerICD-10-CM
H35.1 is a non-billable header ICD-10-CM code for retinopathy of prematurity. It cannot be billed on its own: choose one of the more specific child codes below.
Risk adjustment
H35.1 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 to one of these instead H35.1
8 child codes. Green means billable.
- H35.10Retinopathy of prematurity, unspecified
- H35.11Retinopathy of prematurity, stage 0
- H35.12Retinopathy of prematurity, stage 1
- H35.13Retinopathy of prematurity, stage 2
- H35.14Retinopathy of prematurity, stage 3
- H35.15Retinopathy of prematurity, stage 4
- H35.16Retinopathy of prematurity, stage 5
- H35.17Retrolental fibroplasia
Related codes at this level
Codes that share H35. If H35.1 is not quite right, the correct code is usually one of these.
- H35.0Background retinopathy and retinal vascular changes
- 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 H35.1
- Is H35.1 a billable ICD-10-CM code?
- No. H35.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does H35.1 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of choroid and retina (H30-H36).