H35.3130 — Nonexudative age-related macular degeneration, bilateral, stage unspecified
H35.3130 is a billable, specific ICD-10-CM code for nonexudative age-related macular degeneration, bilateral, stage unspecified. It is valid for submission on a claim.
7th character "0" — stage unspecified
One of the following 7th characters is to be assigned to codes in subcategory H35.31 to designate the stage of the disease:
- 0
- stage unspecified
- 1
- early dry stage
- 2
- intermediate dry stage
- 3
- advanced atrophic without subfoveal involvement
- 4
- advanced atrophic with subfoveal involvement
Risk adjustment
H35.3130 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
H35.3130 is named in 14 Medicare coverage policies — 14 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)
- A56551Billing and Coding: Visual Fields Testing
- A56672Billing and Coding: Electroretinography (ERG)
Related codes at this level
Codes that share H35.313. If H35.3130 is not quite right, the correct code is usually one of these.
- H35.3131Nonexudative age-related macular degeneration, bilateral, early dry stage
- H35.3132Nonexudative age-related macular degeneration, bilateral, intermediate dry stage
- H35.3133Nonexudative age-related macular degeneration, bilateral, advanced atrophic without subfoveal involvement
- H35.3134Nonexudative age-related macular degeneration, bilateral, advanced atrophic with subfoveal involvement
Questions about H35.3130
- Is H35.3130 a billable ICD-10-CM code?
- Yes. H35.3130 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H35.3130 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of choroid and retina (H30-H36).