H35.52
H35.52: Pigmentary retinal dystrophy
Billable / specific codeICD-10-CM
H35.52 is a billable, specific ICD-10-CM code for pigmentary retinal dystrophy. It is valid for submission on a claim.
Check H35.52 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Albipunctate retinal dystrophy
- Retinitis pigmentosa
- Tapetoretinal dystrophy
Excludes1 inherited from the categories above H35.52
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above H35.52
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with H35.52
Their own Excludes1 notes name this code, so the conflict is not listed above.
- Q15Other congenital malformations of eye
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
H35.52 is named in 22 Medicare coverage policies: 22 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
- A54327Billing and Coding: ArgusM II Retinal Prosthesis System
- A56419Billing and Coding: Voretigene Neparvovec-rzyl (Luxturna®)
- A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Alphabetic index entries that lead here
- Retinitis›pigmentosa
- Dystrophy, dystrophia›retinal›pigmentary
Code history
Unchanged in every release from FY2024 to FY2027.