H59.031
H59.031 — Cystoid macular edema following cataract surgery, right eye
Billable / specific codeICD-10-CMright
H59.031 is a billable, specific ICD-10-CM code for cystoid macular edema following cataract surgery, right eye. It is valid for submission on a claim.
Risk adjustment
H59.031 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
H59.031 is named in 9 Medicare coverage policies — 9 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
- A56692Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
- A56774Billing and Coding: Ophthalmic Angiography (Fluorescein and Indocyanine Green)
- A56825Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Related codes at this level
Codes that share H59.03. If H59.031 is not quite right, the correct code is usually one of these.
Questions about H59.031
- Is H59.031 a billable ICD-10-CM code?
- Yes. H59.031 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H59.031 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified (H59).