H36.89
H36.89 — Other retinal disorders in diseases classified elsewhere
Billable / specific codeICD-10-CM
H36.89 is a billable, specific ICD-10-CM code for other retinal disorders in diseases classified elsewhere. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Retinal dystrophy in lipid storage disorders
Risk adjustment
H36.89 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
H36.89 is named in 15 Medicare coverage policies — 15 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53008Billing and Coding: Intraocular Bevacizumab
- 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 H36.8. If H36.89 is not quite right, the correct code is usually one of these.
Questions about H36.89
- Is H36.89 a billable ICD-10-CM code?
- Yes. H36.89 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H36.89 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of choroid and retina (H30-H36).