H35.363
H35.363 — Drusen (degenerative) of macula, bilateral
Billable / specific codeICD-10-CMbilateral
H35.363 is a billable, specific ICD-10-CM code for drusen (degenerative) of macula, bilateral. It is valid for submission on a claim.
Risk adjustment
H35.363 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
H35.363 is named in 19 Medicare coverage policies — 19 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 H35.36. If H35.363 is not quite right, the correct code is usually one of these.
Questions about H35.363
- Is H35.363 a billable ICD-10-CM code?
- Yes. H35.363 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H35.363 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of choroid and retina (H30-H36).