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H43.03

H43.03: Vitreous prolapse, bilateral

Billable / specific codeICD-10-CMbilateral

H43.03 is a billable, specific ICD-10-CM code for vitreous prolapse, bilateral. It is valid for submission on a claim.

Check H43.03 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above H43.03

A category’s note binds every code beneath it.

Written on H43.0: Vitreous prolapse

  • vitreous syndrome following cataract surgery (H59.0-)
  • traumatic vitreous prolapse (S05.2-)

Risk adjustment

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

Medicare coverage

H43.03 is named in 6 Medicare coverage policies: 6 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)
  • A56726Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
  • A57071Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)

Code history

Unchanged in every release from FY2024 to FY2027.

Other codes under H43.0

ICD-10-CMFY2027· effective October 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release: see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.