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H35.343

H35.343: Macular cyst, hole, or pseudohole, bilateral

Billable / specific codeICD-10-CMbilateral

H35.343 is a billable, specific ICD-10-CM code for macular cyst, hole, or pseudohole, bilateral. It is valid for submission on a claim.

Check H35.343 with the rest of the claim: free scrubber

Excludes2 inherited from the categories above H35.343

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

Written on H35: Other retinal disorders

Risk adjustment

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

Medicare coverage

H35.343 is named in 26 Medicare coverage policies: 26 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
  • A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

Code history

Unchanged in every release from FY2024 to FY2027.

Other codes under H35.34

ICD-10-CMFY2027· effective October 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release: see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.