H35.3210 — Exudative age-related macular degeneration, right eye, stage unspecified
H35.3210 is a billable, specific ICD-10-CM code for exudative age-related macular degeneration, right eye, 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 H35.32 to designate the stage of the disease:
- 0
- stage unspecified
- 1
- with active choroidal neovascularization
- 2
- with inactive choroidal neovascularization
- 3
- with inactive scar
Risk adjustment
H35.3210 risk-adjusts. Under the CMS-HCC V28 model it maps to these categories:
- HCC 300 Exudative Macular Degeneration0.596 RAF
- HCC 300 Exudative Macular Degeneration0.596 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
H35.3210 is named in 22 Medicare coverage policies — 22 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52370Billing and Coding: Bevacizumab and biosimilars
- A52451Billing and Coding: Ranibizumab and biosimilars, Aflibercept, Aflibercept HD, Brolucizumab-dbll, Faricimab-svoa, PAVBLU™aflibercept-ayyh, AHZANTIVE®aflibercept-abzv. ENZEEVU™aflibercept-mrbb, OPUVIZ™aflibercept-yszy and YESAFILI™ aflibercept-jbvf
- A52451Billing and Coding: Ranibizumab and biosimilars, Aflibercept, Aflibercept HD, Brolucizumab-dbll, Faricimab-svoa, PAVBLU™aflibercept-ayyh, AHZANTIVE®aflibercept-abzv. ENZEEVU™aflibercept-mrbb, OPUVIZ™aflibercept-yszy and YESAFILI™ aflibercept-jbvf
- A52451Billing and Coding: Ranibizumab and biosimilars, Aflibercept, Aflibercept HD, Brolucizumab-dbll, Faricimab-svoa, PAVBLU™aflibercept-ayyh, AHZANTIVE®aflibercept-abzv. ENZEEVU™aflibercept-mrbb, OPUVIZ™aflibercept-yszy and YESAFILI™ aflibercept-jbvf
Related codes at this level
Codes that share H35.321. If H35.3210 is not quite right, the correct code is usually one of these.
Questions about H35.3210
- Is H35.3210 a billable ICD-10-CM code?
- Yes. H35.3210 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H35.3210 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of choroid and retina (H30-H36).