H35.463

H35.463: Secondary vitreoretinal degeneration, bilateral

Billable / specific codeICD-10-CMbilateral

H35.463 is a billable, specific ICD-10-CM code for secondary vitreoretinal degeneration, bilateral. It is valid for submission on a claim.

Check H35.463 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above H35.463

A category’s note binds every code beneath it.

Written on H35.4: Peripheral retinal degeneration

hereditary retinal degeneration (dystrophy) (H35.5-)

Excludes2 inherited from the categories above H35.463

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

Written on H35.4: Peripheral retinal degeneration

peripheral retinal degeneration with retinal break (H33.3-)

Written on H35: Other retinal disorders

diabetic retinal disorders (E08.311-E08.359, E09.311-E09.359, E10.311-E10.359, E11.311-E11.359, E13.311-E13.359)

Risk adjustment

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

Medicare coverage

H35.463 is named in 19 Medicare coverage policies: 19 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

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)

Code history

Unchanged in every release from FY2024 to FY2027.