H43.11
H43.11 — Vitreous hemorrhage, right eye
Billable / specific codeICD-10-CMright
H43.11 is a billable, specific ICD-10-CM code for vitreous hemorrhage, right eye. It is valid for submission on a claim.
Risk adjustment
H43.11 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 298 Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage0.336 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
H43.11 is named in 13 Medicare coverage policies — 13 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
- A56453Billing and Coding: Cataract Extraction
- A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
- A56544Billing and Coding: Cataract Extraction
Related codes at this level
Codes that share H43.1. If H43.11 is not quite right, the correct code is usually one of these.
Questions about H43.11
- Is H43.11 a billable ICD-10-CM code?
- Yes. H43.11 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H43.11 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of vitreous body and globe (H43-H44).