H35.81
H35.81: Retinal edema
Billable / specific codeICD-10-CM
H35.81 is a billable, specific ICD-10-CM code for retinal edema. It is valid for submission on a claim.
Check H35.81 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Retinal cotton wool spots
Excludes2 inherited from the categories above H35.81
Not part of this code, but both may be coded when both are present.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
H35.81 is named in 27 Medicare coverage policies: 27 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
Alphabetic index entries that lead here
- Cotton wool spots(retinal)
- Congestion, congestive›retina
- Edema, edematous›macula
- Edema, edematous›retina
- Disorder›retina›edema
Code history
Unchanged in every release from FY2024 to FY2027.