H35.21

H35.21: Other non-diabetic proliferative retinopathy, right eye

Billable / specific codeICD-10-CMright

H35.21 is a billable, specific ICD-10-CM code for other non-diabetic proliferative retinopathy, right eye. It is valid for submission on a claim.

Check H35.21 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above H35.21

A category’s note binds every code beneath it.

Written on H35.2: Other non-diabetic proliferative retinopathy

proliferative vitreo-retinopathy with retinal detachment (H33.4-)

Excludes2 inherited from the categories above H35.21

Not part of this code, but both may be coded when both are present.

Written on H35.2: Other non-diabetic proliferative retinopathy

proliferative sickle-cell retinopathy (H36.82-)

Written on H35: Other retinal disorders

diabetic retinal disorders (E08.311-E08.359, E09.311-E09.359, E10.311-E10.359, E11.311-E11.359, E13.311-E13.359)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

H35.21 is named in 24 Medicare coverage policies: 24 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A53008Billing and Coding: Intraocular Bevacizumab
A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
A56453Billing and Coding: Cataract Extraction
A56544Billing and Coding: Cataract Extraction

Code history

Unchanged in every release from FY2024 to FY2027.