H43.823

H43.823: Vitreomacular adhesion, bilateral

Billable / specific codeICD-10-CMbilateral

H43.823 is a billable, specific ICD-10-CM code for vitreomacular adhesion, bilateral. It is valid for submission on a claim.

Check H43.823 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above H43.823

A category’s note binds every code beneath it.

Written on H43.8: Other disorders of vitreous body

proliferative vitreo-retinopathy with retinal detachment (H33.4-)

Excludes2 inherited from the categories above H43.823

Not part of this code, but both may be coded when both are present.

Written on H43.8: Other disorders of vitreous body

vitreous abscess (H44.02-)

Risk adjustment

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

Medicare coverage

H43.823 is named in 14 Medicare coverage policies: 14 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

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

Code history

Unchanged in every release from FY2024 to FY2027.