H35.3212: Exudative age-related macular degeneration, right eye, with inactive choroidal neovascularization
H35.3212 is a billable, specific ICD-10-CM code for exudative age-related macular degeneration, right eye, with inactive choroidal neovascularization. It is valid for submission on a claim.
Check H35.3212 with the rest of the claim: free scrubber7th character "2": with inactive choroidal neovascularization
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
H35.3212 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
H35.3212 is named in 25 Medicare coverage policies: 25 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52370Billing and Coding: Bevacizumab and biosimilars
- A52451Billing and Coding: Ranibizumab, Aflibercept and biosimilars
- A53008Billing and Coding: Intraocular Bevacizumab
- A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Code history
Unchanged in every release from FY2024 to FY2027.