LCD Reference Article Billing and Coding Article

Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

A56916

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Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.

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Source Article ID
N/A
Article ID
A56916
Original ICD-9 Article ID
Not Applicable
Article Title
Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Article Type
Billing and Coding
Original Effective Date
08/29/2019
Revision Effective Date
10/01/2024
Revision Ending Date
N/A
Retirement Date
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Current Dental Terminology © 2023 American Dental Association. All rights reserved.

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Article Text

The billing and coding information in this article is dependent on the coverage indications, limitations and/or medical necessity described in the associated LCD L34760 Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI).

Medicare will consider SCODI medically reasonable and necessary in evaluating retinal disorders, glaucoma, and anterior segment disorders as documented in L34760.

Coding Guidelines:
For claims submitted to the Part B MAC:
All services/procedures performed on the same day for the same beneficiary by the physician/provider should be billed on the same claim.

Claims for SCODI services (CPT codes 92133 and 92134) are payable under Medicare Part B in the following places of service:

  • The global service is payable in the office (11), nursing facility (32- for Medicare patient not in a Part A stay) and independent clinic (49).
  • The technical component (modifier TC) is payable in the office (11), nursing facility (32- for Medicare patient not in a Part A stay), independent clinic (49), federally qualified health center (50), and rural health clinic (72).
  • The professional component (modifier 26) is payable in the office (11), inpatient hospital (21), Off campus-outpatient hospital (19), On campus- outpatient hospital (22), skilled nursing facility (31), nursing facility (32- for Medicare patient not in a Part A stay), and independent clinic (49).

Please review 100-04 Medicare Claims Processing Manual, Chapter 32 - Billing Requirements for Special Services, Section 300.2 for Claims Processing Requirements for OPT with Verteporfin Services on Professional Claims and Outpatient Facility Claims.

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Group 1

Group 1 Paragraph

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ICD-10-CM Codes that Support Medical Necessity

Group 1

(274 Codes)
Group 1 Paragraph

For CPT code 92132 – anterior segment:
For the codes in the table that require a 7th character, the codes will be allowed for A initial encounter, D subsequent encounter and S sequel.

Group 1 Codes
Code Description
C69.01 Malignant neoplasm of right conjunctiva
C69.02 Malignant neoplasm of left conjunctiva
C69.11 Malignant neoplasm of right cornea
C69.12 Malignant neoplasm of left cornea
C69.21 Malignant neoplasm of right retina
C69.22 Malignant neoplasm of left retina
C69.31 Malignant neoplasm of right choroid
C69.32 Malignant neoplasm of left choroid
C69.41 Malignant neoplasm of right ciliary body
C69.42 Malignant neoplasm of left ciliary body
C69.51 Malignant neoplasm of right lacrimal gland and duct
C69.52 Malignant neoplasm of left lacrimal gland and duct
C69.61 Malignant neoplasm of right orbit
C69.62 Malignant neoplasm of left orbit
C69.81 Malignant neoplasm of overlapping sites of right eye and adnexa
C69.82 Malignant neoplasm of overlapping sites of left eye and adnexa
D31.01 Benign neoplasm of right conjunctiva
D31.02 Benign neoplasm of left conjunctiva
D31.11 Benign neoplasm of right cornea
D31.12 Benign neoplasm of left cornea
D31.21 Benign neoplasm of right retina
D31.22 Benign neoplasm of left retina
D31.31 Benign neoplasm of right choroid
D31.32 Benign neoplasm of left choroid
D31.41 Benign neoplasm of right ciliary body
D31.42 Benign neoplasm of left ciliary body
D31.51 Benign neoplasm of right lacrimal gland and duct
D31.52 Benign neoplasm of left lacrimal gland and duct
D31.61 Benign neoplasm of unspecified site of right orbit
D31.62 Benign neoplasm of unspecified site of left orbit
D31.91 Benign neoplasm of unspecified part of right eye
D31.92 Benign neoplasm of unspecified part of left eye
H16.001 Unspecified corneal ulcer, right eye
H16.002 Unspecified corneal ulcer, left eye
H16.003 Unspecified corneal ulcer, bilateral
H16.011 Central corneal ulcer, right eye
H16.012 Central corneal ulcer, left eye
H16.013 Central corneal ulcer, bilateral
H16.021 Ring corneal ulcer, right eye
H16.022 Ring corneal ulcer, left eye
H16.023 Ring corneal ulcer, bilateral
H16.031 Corneal ulcer with hypopyon, right eye
H16.032 Corneal ulcer with hypopyon, left eye
H16.033 Corneal ulcer with hypopyon, bilateral
H16.041 Marginal corneal ulcer, right eye
H16.042 Marginal corneal ulcer, left eye
H16.043 Marginal corneal ulcer, bilateral
H16.051 Mooren's corneal ulcer, right eye
H16.052 Mooren's corneal ulcer, left eye
H16.053 Mooren's corneal ulcer, bilateral
H16.061 Mycotic corneal ulcer, right eye
H16.062 Mycotic corneal ulcer, left eye
H16.063 Mycotic corneal ulcer, bilateral
H16.071 Perforated corneal ulcer, right eye
H16.072 Perforated corneal ulcer, left eye
H16.073 Perforated corneal ulcer, bilateral
H18.11 Bullous keratopathy, right eye
H18.12 Bullous keratopathy, left eye
H18.13 Bullous keratopathy, bilateral
H18.20 Unspecified corneal edema
H18.211 Corneal edema secondary to contact lens, right eye
H18.212 Corneal edema secondary to contact lens, left eye
H18.213 Corneal edema secondary to contact lens, bilateral
H18.221 Idiopathic corneal edema, right eye
H18.222 Idiopathic corneal edema, left eye
H18.223 Idiopathic corneal edema, bilateral
H18.231 Secondary corneal edema, right eye
H18.232 Secondary corneal edema, left eye
H18.233 Secondary corneal edema, bilateral
H18.501 Unspecified hereditary corneal dystrophies, right eye
H18.502 Unspecified hereditary corneal dystrophies, left eye
H18.503 Unspecified hereditary corneal dystrophies, bilateral
H18.511 Endothelial corneal dystrophy, right eye
H18.512 Endothelial corneal dystrophy, left eye
H18.513 Endothelial corneal dystrophy, bilateral
H18.711 Corneal ectasia, right eye
H18.712 Corneal ectasia, left eye
H18.713 Corneal ectasia, bilateral
H18.721 Corneal staphyloma, right eye
H18.722 Corneal staphyloma, left eye
H18.723 Corneal staphyloma, bilateral
H18.731 Descemetocele, right eye
H18.732 Descemetocele, left eye
H18.733 Descemetocele, bilateral
H40.021 Open angle with borderline findings, high risk, right eye
H40.022 Open angle with borderline findings, high risk, left eye
H40.023 Open angle with borderline findings, high risk, bilateral
H40.031 Anatomical narrow angle, right eye
H40.032 Anatomical narrow angle, left eye
H40.033 Anatomical narrow angle, bilateral
H40.061 Primary angle closure without glaucoma damage, right eye
H40.062 Primary angle closure without glaucoma damage, left eye
H40.063 Primary angle closure without glaucoma damage, bilateral
H40.1110 Primary open-angle glaucoma, right eye, stage unspecified
H40.1111 Primary open-angle glaucoma, right eye, mild stage
H40.1112 Primary open-angle glaucoma, right eye, moderate stage
H40.1113 Primary open-angle glaucoma, right eye, severe stage
H40.1114 Primary open-angle glaucoma, right eye, indeterminate stage
H40.1120 Primary open-angle glaucoma, left eye, stage unspecified
H40.1121 Primary open-angle glaucoma, left eye, mild stage
H40.1122 Primary open-angle glaucoma, left eye, moderate stage
H40.1123 Primary open-angle glaucoma, left eye, severe stage
H40.1124 Primary open-angle glaucoma, left eye, indeterminate stage
H40.1130 Primary open-angle glaucoma, bilateral, stage unspecified
H40.1131 Primary open-angle glaucoma, bilateral, mild stage
H40.1132 Primary open-angle glaucoma, bilateral, moderate stage
H40.1133 Primary open-angle glaucoma, bilateral, severe stage
H40.1134 Primary open-angle glaucoma, bilateral, indeterminate stage
H40.1210 Low-tension glaucoma, right eye, stage unspecified
H40.1211 Low-tension glaucoma, right eye, mild stage
H40.1212 Low-tension glaucoma, right eye, moderate stage
H40.1213 Low-tension glaucoma, right eye, severe stage
H40.1214 Low-tension glaucoma, right eye, indeterminate stage
H40.1220 Low-tension glaucoma, left eye, stage unspecified
H40.1221 Low-tension glaucoma, left eye, mild stage
H40.1222 Low-tension glaucoma, left eye, moderate stage
H40.1223 Low-tension glaucoma, left eye, severe stage
H40.1224 Low-tension glaucoma, left eye, indeterminate stage
H40.1230 Low-tension glaucoma, bilateral, stage unspecified
H40.1231 Low-tension glaucoma, bilateral, mild stage
H40.1232 Low-tension glaucoma, bilateral, moderate stage
H40.1233 Low-tension glaucoma, bilateral, severe stage
H40.1234 Low-tension glaucoma, bilateral, indeterminate stage
H40.1290 Low-tension glaucoma, unspecified eye, stage unspecified
H40.1291 Low-tension glaucoma, unspecified eye, mild stage
H40.1292 Low-tension glaucoma, unspecified eye, moderate stage
H40.1293 Low-tension glaucoma, unspecified eye, severe stage
H40.1294 Low-tension glaucoma, unspecified eye, indeterminate stage
H40.1310 Pigmentary glaucoma, right eye, stage unspecified
H40.1311 Pigmentary glaucoma, right eye, mild stage
H40.1312 Pigmentary glaucoma, right eye, moderate stage
H40.1313 Pigmentary glaucoma, right eye, severe stage
H40.1314 Pigmentary glaucoma, right eye, indeterminate stage
H40.1320 Pigmentary glaucoma, left eye, stage unspecified
H40.1321 Pigmentary glaucoma, left eye, mild stage
H40.1322 Pigmentary glaucoma, left eye, moderate stage
H40.1323 Pigmentary glaucoma, left eye, severe stage
H40.1324 Pigmentary glaucoma, left eye, indeterminate stage
H40.1330 Pigmentary glaucoma, bilateral, stage unspecified
H40.1331 Pigmentary glaucoma, bilateral, mild stage
H40.1332 Pigmentary glaucoma, bilateral, moderate stage
H40.1333 Pigmentary glaucoma, bilateral, severe stage
H40.1334 Pigmentary glaucoma, bilateral, indeterminate stage
H40.1410 Capsular glaucoma with pseudoexfoliation of lens, right eye, stage unspecified
H40.1411 Capsular glaucoma with pseudoexfoliation of lens, right eye, mild stage
H40.1412 Capsular glaucoma with pseudoexfoliation of lens, right eye, moderate stage
H40.1413 Capsular glaucoma with pseudoexfoliation of lens, right eye, severe stage
H40.1414 Capsular glaucoma with pseudoexfoliation of lens, right eye, indeterminate stage
H40.1420 Capsular glaucoma with pseudoexfoliation of lens, left eye, stage unspecified
H40.1421 Capsular glaucoma with pseudoexfoliation of lens, left eye, mild stage
H40.1422 Capsular glaucoma with pseudoexfoliation of lens, left eye, moderate stage
H40.1423 Capsular glaucoma with pseudoexfoliation of lens, left eye, severe stage
H40.1424 Capsular glaucoma with pseudoexfoliation of lens, left eye, indeterminate stage
H40.1430 Capsular glaucoma with pseudoexfoliation of lens, bilateral, stage unspecified
H40.1431 Capsular glaucoma with pseudoexfoliation of lens, bilateral, mild stage
H40.1432 Capsular glaucoma with pseudoexfoliation of lens, bilateral, moderate stage
H40.1433 Capsular glaucoma with pseudoexfoliation of lens, bilateral, severe stage
H40.1434 Capsular glaucoma with pseudoexfoliation of lens, bilateral, indeterminate stage
H40.20X1 Unspecified primary angle-closure glaucoma, mild stage
H40.20X2 Unspecified primary angle-closure glaucoma, moderate stage
H40.20X3 Unspecified primary angle-closure glaucoma, severe stage
H40.20X4 Unspecified primary angle-closure glaucoma, indeterminate stage
H40.211 Acute angle-closure glaucoma, right eye
H40.212 Acute angle-closure glaucoma, left eye
H40.213 Acute angle-closure glaucoma, bilateral
H40.2210 Chronic angle-closure glaucoma, right eye, stage unspecified
H40.2211 Chronic angle-closure glaucoma, right eye, mild stage
H40.2212 Chronic angle-closure glaucoma, right eye, moderate stage
H40.2213 Chronic angle-closure glaucoma, right eye, severe stage
H40.2214 Chronic angle-closure glaucoma, right eye, indeterminate stage
H40.2220 Chronic angle-closure glaucoma, left eye, stage unspecified
H40.2221 Chronic angle-closure glaucoma, left eye, mild stage
H40.2222 Chronic angle-closure glaucoma, left eye, moderate stage
H40.2223 Chronic angle-closure glaucoma, left eye, severe stage
H40.2224 Chronic angle-closure glaucoma, left eye, indeterminate stage
H40.2230 Chronic angle-closure glaucoma, bilateral, stage unspecified
H40.2231 Chronic angle-closure glaucoma, bilateral, mild stage
H40.2232 Chronic angle-closure glaucoma, bilateral, moderate stage
H40.2233 Chronic angle-closure glaucoma, bilateral, severe stage
H40.2234 Chronic angle-closure glaucoma, bilateral, indeterminate stage
H40.231 Intermittent angle-closure glaucoma, right eye
H40.232 Intermittent angle-closure glaucoma, left eye
H40.233 Intermittent angle-closure glaucoma, bilateral
H40.241 Residual stage of angle-closure glaucoma, right eye
H40.242 Residual stage of angle-closure glaucoma, left eye
H40.243 Residual stage of angle-closure glaucoma, bilateral
H40.31X0 Glaucoma secondary to eye trauma, right eye, stage unspecified
H40.31X1 Glaucoma secondary to eye trauma, right eye, mild stage
H40.31X2 Glaucoma secondary to eye trauma, right eye, moderate stage
H40.31X3 Glaucoma secondary to eye trauma, right eye, severe stage
H40.31X4 Glaucoma secondary to eye trauma, right eye, indeterminate stage
H40.32X0 Glaucoma secondary to eye trauma, left eye, stage unspecified
H40.32X1 Glaucoma secondary to eye trauma, left eye, mild stage
H40.32X2 Glaucoma secondary to eye trauma, left eye, moderate stage
H40.32X3 Glaucoma secondary to eye trauma, left eye, severe stage
H40.32X4 Glaucoma secondary to eye trauma, left eye, indeterminate stage
H40.33X0 Glaucoma secondary to eye trauma, bilateral, stage unspecified
H40.33X1 Glaucoma secondary to eye trauma, bilateral, mild stage
H40.33X2 Glaucoma secondary to eye trauma, bilateral, moderate stage
H40.33X3 Glaucoma secondary to eye trauma, bilateral, severe stage
H40.33X4 Glaucoma secondary to eye trauma, bilateral, indeterminate stage
H40.41X0 Glaucoma secondary to eye inflammation, right eye, stage unspecified
H40.41X1 Glaucoma secondary to eye inflammation, right eye, mild stage
H40.41X2 Glaucoma secondary to eye inflammation, right eye, moderate stage
H40.41X3 Glaucoma secondary to eye inflammation, right eye, severe stage
H40.41X4 Glaucoma secondary to eye inflammation, right eye, indeterminate stage
H40.42X0 Glaucoma secondary to eye inflammation, left eye, stage unspecified
H40.42X1 Glaucoma secondary to eye inflammation, left eye, mild stage
H40.42X2 Glaucoma secondary to eye inflammation, left eye, moderate stage
H40.42X3 Glaucoma secondary to eye inflammation, left eye, severe stage
H40.42X4 Glaucoma secondary to eye inflammation, left eye, indeterminate stage
H40.43X0 Glaucoma secondary to eye inflammation, bilateral, stage unspecified
H40.43X1 Glaucoma secondary to eye inflammation, bilateral, mild stage
H40.43X2 Glaucoma secondary to eye inflammation, bilateral, moderate stage
H40.43X3 Glaucoma secondary to eye inflammation, bilateral, severe stage
H40.43X4 Glaucoma secondary to eye inflammation, bilateral, indeterminate stage
H40.51X0 Glaucoma secondary to other eye disorders, right eye, stage unspecified
H40.51X1 Glaucoma secondary to other eye disorders, right eye, mild stage
H40.51X2 Glaucoma secondary to other eye disorders, right eye, moderate stage
H40.51X3 Glaucoma secondary to other eye disorders, right eye, severe stage
H40.51X4 Glaucoma secondary to other eye disorders, right eye, indeterminate stage
H40.52X0 Glaucoma secondary to other eye disorders, left eye, stage unspecified
H40.52X1 Glaucoma secondary to other eye disorders, left eye, mild stage
H40.52X2 Glaucoma secondary to other eye disorders, left eye, moderate stage
H40.52X3 Glaucoma secondary to other eye disorders, left eye, severe stage
H40.52X4 Glaucoma secondary to other eye disorders, left eye, indeterminate stage
H40.53X0 Glaucoma secondary to other eye disorders, bilateral, stage unspecified
H40.53X1 Glaucoma secondary to other eye disorders, bilateral, mild stage
H40.53X2 Glaucoma secondary to other eye disorders, bilateral, moderate stage
H40.53X3 Glaucoma secondary to other eye disorders, bilateral, severe stage
H40.53X4 Glaucoma secondary to other eye disorders, bilateral, indeterminate stage
H40.61X0 Glaucoma secondary to drugs, right eye, stage unspecified
H40.61X1 Glaucoma secondary to drugs, right eye, mild stage
H40.61X2 Glaucoma secondary to drugs, right eye, moderate stage
H40.61X3 Glaucoma secondary to drugs, right eye, severe stage
H40.61X4 Glaucoma secondary to drugs, right eye, indeterminate stage
H40.62X0 Glaucoma secondary to drugs, left eye, stage unspecified
H40.62X1 Glaucoma secondary to drugs, left eye, mild stage
H40.62X2 Glaucoma secondary to drugs, left eye, moderate stage
H40.62X3 Glaucoma secondary to drugs, left eye, severe stage
H40.62X4 Glaucoma secondary to drugs, left eye, indeterminate stage
H40.63X0 Glaucoma secondary to drugs, bilateral, stage unspecified
H40.63X1 Glaucoma secondary to drugs, bilateral, mild stage
H40.63X2 Glaucoma secondary to drugs, bilateral, moderate stage
H40.63X3 Glaucoma secondary to drugs, bilateral, severe stage
H40.63X4 Glaucoma secondary to drugs, bilateral, indeterminate stage
H40.811 Glaucoma with increased episcleral venous pressure, right eye
H40.812 Glaucoma with increased episcleral venous pressure, left eye
H40.813 Glaucoma with increased episcleral venous pressure, bilateral
H40.821 Hypersecretion glaucoma, right eye
H40.822 Hypersecretion glaucoma, left eye
H40.823 Hypersecretion glaucoma, bilateral
H40.831 Aqueous misdirection, right eye
H40.832 Aqueous misdirection, left eye
H40.833 Aqueous misdirection, bilateral
H40.89 Other specified glaucoma
H42 Glaucoma in diseases classified elsewhere
Q15.0 Congenital glaucoma
T85.21XA Breakdown (mechanical) of intraocular lens, initial encounter
T85.22XA Displacement of intraocular lens, initial encounter
T85.29XA Other mechanical complication of intraocular lens, initial encounter
T85.318A Breakdown (mechanical) of other ocular prosthetic devices, implants and grafts, initial encounter
T85.328A Displacement of other ocular prosthetic devices, implants and grafts, initial encounter
T85.398A Other mechanical complication of other ocular prosthetic devices, implants and grafts, initial encounter
T85.79XA Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts, initial encounter
T86.8401 Corneal transplant rejection, right eye
T86.8402 Corneal transplant rejection, left eye
T86.8403 Corneal transplant rejection, bilateral
T86.8411 Corneal transplant failure, right eye
T86.8412 Corneal transplant failure, left eye
T86.8413 Corneal transplant failure, bilateral
T86.8421 Corneal transplant infection, right eye
T86.8422 Corneal transplant infection, left eye
T86.8423 Corneal transplant infection, bilateral

Group 2

(241 Codes)
Group 2 Paragraph

For CPT code 92133-optic nerve

Group 2 Codes
Code Description
H21.551 Recession of chamber angle, right eye
H21.552 Recession of chamber angle, left eye
H21.553 Recession of chamber angle, bilateral
H40.001 Preglaucoma, unspecified, right eye
H40.002 Preglaucoma, unspecified, left eye
H40.003 Preglaucoma, unspecified, bilateral
H40.011 Open angle with borderline findings, low risk, right eye
H40.012 Open angle with borderline findings, low risk, left eye
H40.013 Open angle with borderline findings, low risk, bilateral
H40.021 Open angle with borderline findings, high risk, right eye
H40.022 Open angle with borderline findings, high risk, left eye
H40.023 Open angle with borderline findings, high risk, bilateral
H40.031 Anatomical narrow angle, right eye
H40.032 Anatomical narrow angle, left eye
H40.033 Anatomical narrow angle, bilateral
H40.041 Steroid responder, right eye
H40.042 Steroid responder, left eye
H40.043 Steroid responder, bilateral
H40.051 Ocular hypertension, right eye
H40.052 Ocular hypertension, left eye
H40.053 Ocular hypertension, bilateral
H40.061 Primary angle closure without glaucoma damage, right eye
H40.062 Primary angle closure without glaucoma damage, left eye
H40.063 Primary angle closure without glaucoma damage, bilateral
H40.10X0 Unspecified open-angle glaucoma, stage unspecified
H40.10X1 Unspecified open-angle glaucoma, mild stage
H40.10X2 Unspecified open-angle glaucoma, moderate stage
H40.10X3 Unspecified open-angle glaucoma, severe stage
H40.10X4 Unspecified open-angle glaucoma, indeterminate stage
H40.1110 Primary open-angle glaucoma, right eye, stage unspecified
H40.1111 Primary open-angle glaucoma, right eye, mild stage
H40.1112 Primary open-angle glaucoma, right eye, moderate stage
H40.1113 Primary open-angle glaucoma, right eye, severe stage
H40.1114 Primary open-angle glaucoma, right eye, indeterminate stage
H40.1120 Primary open-angle glaucoma, left eye, stage unspecified
H40.1121 Primary open-angle glaucoma, left eye, mild stage
H40.1122 Primary open-angle glaucoma, left eye, moderate stage
H40.1123 Primary open-angle glaucoma, left eye, severe stage
H40.1124 Primary open-angle glaucoma, left eye, indeterminate stage
H40.1130 Primary open-angle glaucoma, bilateral, stage unspecified
H40.1131 Primary open-angle glaucoma, bilateral, mild stage
H40.1132 Primary open-angle glaucoma, bilateral, moderate stage
H40.1133 Primary open-angle glaucoma, bilateral, severe stage
H40.1134 Primary open-angle glaucoma, bilateral, indeterminate stage
H40.1210 Low-tension glaucoma, right eye, stage unspecified
H40.1211 Low-tension glaucoma, right eye, mild stage
H40.1212 Low-tension glaucoma, right eye, moderate stage
H40.1213 Low-tension glaucoma, right eye, severe stage
H40.1214 Low-tension glaucoma, right eye, indeterminate stage
H40.1220 Low-tension glaucoma, left eye, stage unspecified
H40.1221 Low-tension glaucoma, left eye, mild stage
H40.1222 Low-tension glaucoma, left eye, moderate stage
H40.1223 Low-tension glaucoma, left eye, severe stage
H40.1224 Low-tension glaucoma, left eye, indeterminate stage
H40.1230 Low-tension glaucoma, bilateral, stage unspecified
H40.1231 Low-tension glaucoma, bilateral, mild stage
H40.1232 Low-tension glaucoma, bilateral, moderate stage
H40.1233 Low-tension glaucoma, bilateral, severe stage
H40.1234 Low-tension glaucoma, bilateral, indeterminate stage
H40.1310 Pigmentary glaucoma, right eye, stage unspecified
H40.1311 Pigmentary glaucoma, right eye, mild stage
H40.1312 Pigmentary glaucoma, right eye, moderate stage
H40.1313 Pigmentary glaucoma, right eye, severe stage
H40.1314 Pigmentary glaucoma, right eye, indeterminate stage
H40.1320 Pigmentary glaucoma, left eye, stage unspecified
H40.1321 Pigmentary glaucoma, left eye, mild stage
H40.1322 Pigmentary glaucoma, left eye, moderate stage
H40.1323 Pigmentary glaucoma, left eye, severe stage
H40.1324 Pigmentary glaucoma, left eye, indeterminate stage
H40.1330 Pigmentary glaucoma, bilateral, stage unspecified
H40.1331 Pigmentary glaucoma, bilateral, mild stage
H40.1332 Pigmentary glaucoma, bilateral, moderate stage
H40.1333 Pigmentary glaucoma, bilateral, severe stage
H40.1334 Pigmentary glaucoma, bilateral, indeterminate stage
H40.1410 Capsular glaucoma with pseudoexfoliation of lens, right eye, stage unspecified
H40.1411 Capsular glaucoma with pseudoexfoliation of lens, right eye, mild stage
H40.1412 Capsular glaucoma with pseudoexfoliation of lens, right eye, moderate stage
H40.1413 Capsular glaucoma with pseudoexfoliation of lens, right eye, severe stage
H40.1414 Capsular glaucoma with pseudoexfoliation of lens, right eye, indeterminate stage
H40.1420 Capsular glaucoma with pseudoexfoliation of lens, left eye, stage unspecified
H40.1421 Capsular glaucoma with pseudoexfoliation of lens, left eye, mild stage
H40.1422 Capsular glaucoma with pseudoexfoliation of lens, left eye, moderate stage
H40.1423 Capsular glaucoma with pseudoexfoliation of lens, left eye, severe stage
H40.1424 Capsular glaucoma with pseudoexfoliation of lens, left eye, indeterminate stage
H40.1430 Capsular glaucoma with pseudoexfoliation of lens, bilateral, stage unspecified
H40.1431 Capsular glaucoma with pseudoexfoliation of lens, bilateral, mild stage
H40.1432 Capsular glaucoma with pseudoexfoliation of lens, bilateral, moderate stage
H40.1433 Capsular glaucoma with pseudoexfoliation of lens, bilateral, severe stage
H40.1434 Capsular glaucoma with pseudoexfoliation of lens, bilateral, indeterminate stage
H40.151 Residual stage of open-angle glaucoma, right eye
H40.152 Residual stage of open-angle glaucoma, left eye
H40.153 Residual stage of open-angle glaucoma, bilateral
H40.20X0 Unspecified primary angle-closure glaucoma, stage unspecified
H40.20X1 Unspecified primary angle-closure glaucoma, mild stage
H40.20X2 Unspecified primary angle-closure glaucoma, moderate stage
H40.20X3 Unspecified primary angle-closure glaucoma, severe stage
H40.20X4 Unspecified primary angle-closure glaucoma, indeterminate stage
H40.211 Acute angle-closure glaucoma, right eye
H40.212 Acute angle-closure glaucoma, left eye
H40.213 Acute angle-closure glaucoma, bilateral
H40.2210 Chronic angle-closure glaucoma, right eye, stage unspecified
H40.2211 Chronic angle-closure glaucoma, right eye, mild stage
H40.2212 Chronic angle-closure glaucoma, right eye, moderate stage
H40.2213 Chronic angle-closure glaucoma, right eye, severe stage
H40.2214 Chronic angle-closure glaucoma, right eye, indeterminate stage
H40.2220 Chronic angle-closure glaucoma, left eye, stage unspecified
H40.2221 Chronic angle-closure glaucoma, left eye, mild stage
H40.2222 Chronic angle-closure glaucoma, left eye, moderate stage
H40.2223 Chronic angle-closure glaucoma, left eye, severe stage
H40.2224 Chronic angle-closure glaucoma, left eye, indeterminate stage
H40.2230 Chronic angle-closure glaucoma, bilateral, stage unspecified
H40.2231 Chronic angle-closure glaucoma, bilateral, mild stage
H40.2232 Chronic angle-closure glaucoma, bilateral, moderate stage
H40.2233 Chronic angle-closure glaucoma, bilateral, severe stage
H40.2234 Chronic angle-closure glaucoma, bilateral, indeterminate stage
H40.231 Intermittent angle-closure glaucoma, right eye
H40.232 Intermittent angle-closure glaucoma, left eye
H40.233 Intermittent angle-closure glaucoma, bilateral
H40.241 Residual stage of angle-closure glaucoma, right eye
H40.242 Residual stage of angle-closure glaucoma, left eye
H40.243 Residual stage of angle-closure glaucoma, bilateral
H40.31X0 Glaucoma secondary to eye trauma, right eye, stage unspecified
H40.31X1 Glaucoma secondary to eye trauma, right eye, mild stage
H40.31X2 Glaucoma secondary to eye trauma, right eye, moderate stage
H40.31X3 Glaucoma secondary to eye trauma, right eye, severe stage
H40.31X4 Glaucoma secondary to eye trauma, right eye, indeterminate stage
H40.32X0 Glaucoma secondary to eye trauma, left eye, stage unspecified
H40.32X1 Glaucoma secondary to eye trauma, left eye, mild stage
H40.32X2 Glaucoma secondary to eye trauma, left eye, moderate stage
H40.32X3 Glaucoma secondary to eye trauma, left eye, severe stage
H40.32X4 Glaucoma secondary to eye trauma, left eye, indeterminate stage
H40.33X0 Glaucoma secondary to eye trauma, bilateral, stage unspecified
H40.33X1 Glaucoma secondary to eye trauma, bilateral, mild stage
H40.33X2 Glaucoma secondary to eye trauma, bilateral, moderate stage
H40.33X3 Glaucoma secondary to eye trauma, bilateral, severe stage
H40.33X4 Glaucoma secondary to eye trauma, bilateral, indeterminate stage
H40.41X0 Glaucoma secondary to eye inflammation, right eye, stage unspecified
H40.41X1 Glaucoma secondary to eye inflammation, right eye, mild stage
H40.41X2 Glaucoma secondary to eye inflammation, right eye, moderate stage
H40.41X3 Glaucoma secondary to eye inflammation, right eye, severe stage
H40.41X4 Glaucoma secondary to eye inflammation, right eye, indeterminate stage
H40.42X0 Glaucoma secondary to eye inflammation, left eye, stage unspecified
H40.42X1 Glaucoma secondary to eye inflammation, left eye, mild stage
H40.42X2 Glaucoma secondary to eye inflammation, left eye, moderate stage
H40.42X3 Glaucoma secondary to eye inflammation, left eye, severe stage
H40.42X4 Glaucoma secondary to eye inflammation, left eye, indeterminate stage
H40.43X0 Glaucoma secondary to eye inflammation, bilateral, stage unspecified
H40.43X1 Glaucoma secondary to eye inflammation, bilateral, mild stage
H40.43X2 Glaucoma secondary to eye inflammation, bilateral, moderate stage
H40.43X3 Glaucoma secondary to eye inflammation, bilateral, severe stage
H40.43X4 Glaucoma secondary to eye inflammation, bilateral, indeterminate stage
H40.51X0 Glaucoma secondary to other eye disorders, right eye, stage unspecified
H40.51X1 Glaucoma secondary to other eye disorders, right eye, mild stage
H40.51X2 Glaucoma secondary to other eye disorders, right eye, moderate stage
H40.51X3 Glaucoma secondary to other eye disorders, right eye, severe stage
H40.51X4 Glaucoma secondary to other eye disorders, right eye, indeterminate stage
H40.52X0 Glaucoma secondary to other eye disorders, left eye, stage unspecified
H40.52X1 Glaucoma secondary to other eye disorders, left eye, mild stage
H40.52X2 Glaucoma secondary to other eye disorders, left eye, moderate stage
H40.52X3 Glaucoma secondary to other eye disorders, left eye, severe stage
H40.52X4 Glaucoma secondary to other eye disorders, left eye, indeterminate stage
H40.53X0 Glaucoma secondary to other eye disorders, bilateral, stage unspecified
H40.53X1 Glaucoma secondary to other eye disorders, bilateral, mild stage
H40.53X2 Glaucoma secondary to other eye disorders, bilateral, moderate stage
H40.53X3 Glaucoma secondary to other eye disorders, bilateral, severe stage
H40.53X4 Glaucoma secondary to other eye disorders, bilateral, indeterminate stage
H40.61X0 Glaucoma secondary to drugs, right eye, stage unspecified
H40.61X1 Glaucoma secondary to drugs, right eye, mild stage
H40.61X2 Glaucoma secondary to drugs, right eye, moderate stage
H40.61X3 Glaucoma secondary to drugs, right eye, severe stage
H40.61X4 Glaucoma secondary to drugs, right eye, indeterminate stage
H40.62X0 Glaucoma secondary to drugs, left eye, stage unspecified
H40.62X1 Glaucoma secondary to drugs, left eye, mild stage
H40.62X2 Glaucoma secondary to drugs, left eye, moderate stage
H40.62X3 Glaucoma secondary to drugs, left eye, severe stage
H40.62X4 Glaucoma secondary to drugs, left eye, indeterminate stage
H40.63X0 Glaucoma secondary to drugs, bilateral, stage unspecified
H40.63X1 Glaucoma secondary to drugs, bilateral, mild stage
H40.63X2 Glaucoma secondary to drugs, bilateral, moderate stage
H40.63X3 Glaucoma secondary to drugs, bilateral, severe stage
H40.63X4 Glaucoma secondary to drugs, bilateral, indeterminate stage
H40.811 Glaucoma with increased episcleral venous pressure, right eye
H40.812 Glaucoma with increased episcleral venous pressure, left eye
H40.813 Glaucoma with increased episcleral venous pressure, bilateral
H40.821 Hypersecretion glaucoma, right eye
H40.822 Hypersecretion glaucoma, left eye
H40.823 Hypersecretion glaucoma, bilateral
H40.831 Aqueous misdirection, right eye
H40.832 Aqueous misdirection, left eye
H40.833 Aqueous misdirection, bilateral
H40.89 Other specified glaucoma
H40.9 Unspecified glaucoma
H42 Glaucoma in diseases classified elsewhere
H46.01 Optic papillitis, right eye
H46.02 Optic papillitis, left eye
H46.03 Optic papillitis, bilateral
H46.11 Retrobulbar neuritis, right eye
H46.12 Retrobulbar neuritis, left eye
H46.13 Retrobulbar neuritis, bilateral
H46.9 Unspecified optic neuritis
H47.011 Ischemic optic neuropathy, right eye
H47.012 Ischemic optic neuropathy, left eye
H47.013 Ischemic optic neuropathy, bilateral
H47.10 Unspecified papilledema
H47.11 Papilledema associated with increased intracranial pressure
H47.12 Papilledema associated with decreased ocular pressure
H47.13 Papilledema associated with retinal disorder
H47.141 Foster-Kennedy syndrome, right eye
H47.142 Foster-Kennedy syndrome, left eye
H47.143 Foster-Kennedy syndrome, bilateral
H47.231 Glaucomatous optic atrophy, right eye
H47.232 Glaucomatous optic atrophy, left eye
H47.233 Glaucomatous optic atrophy, bilateral
H47.291 Other optic atrophy, right eye
H47.292 Other optic atrophy, left eye
H47.293 Other optic atrophy, bilateral
H47.321 Drusen of optic disc, right eye
H47.322 Drusen of optic disc, left eye
H47.323 Drusen of optic disc, bilateral
H47.331 Pseudopapilledema of optic disc, right eye
H47.332 Pseudopapilledema of optic disc, left eye
H47.333 Pseudopapilledema of optic disc, bilateral
H47.9 Unspecified disorder of visual pathways
H53.15 Visual distortions of shape and size
H53.40 Unspecified visual field defects
H53.411 Scotoma involving central area, right eye
H53.412 Scotoma involving central area, left eye
H53.413 Scotoma involving central area, bilateral
H53.421 Scotoma of blind spot area, right eye
H53.422 Scotoma of blind spot area, left eye
H53.423 Scotoma of blind spot area, bilateral
H53.431 Sector or arcuate defects, right eye
H53.432 Sector or arcuate defects, left eye
H53.433 Sector or arcuate defects, bilateral
H53.451 Other localized visual field defect, right eye
H53.452 Other localized visual field defect, left eye
H53.453 Other localized visual field defect, bilateral
H53.481 Generalized contraction of visual field, right eye
H53.482 Generalized contraction of visual field, left eye
H53.483 Generalized contraction of visual field, bilateral
Q15.0 Congenital glaucoma

Group 3

(461 Codes)
Group 3 Paragraph

For CPT code 92134-retina

Group 3 Codes
Code Description
A18.53 Tuberculous chorioretinitis
B39.4 Histoplasmosis capsulati, unspecified
B39.5 Histoplasmosis duboisii
B39.9 Histoplasmosis, unspecified
C69.31 Malignant neoplasm of right choroid
C69.32 Malignant neoplasm of left choroid
D18.09 Hemangioma of other sites
D31.31 Benign neoplasm of right choroid
D31.32 Benign neoplasm of left choroid
E08.311 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema
E08.319 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy without macular edema
E08.3211 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, right eye
E08.3212 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, left eye
E08.3213 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E08.3291 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, right eye
E08.3292 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, left eye
E08.3293 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E08.3311 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, right eye
E08.3312 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, left eye
E08.3313 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E08.3391 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, right eye
E08.3392 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, left eye
E08.3393 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E08.3411 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, right eye
E08.3412 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, left eye
E08.3413 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E08.3491 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, right eye
E08.3492 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, left eye
E08.3493 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E08.3511 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, right eye
E08.3512 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, left eye
E08.3513 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, bilateral
E08.3521 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
E08.3522 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
E08.3523 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E08.3529 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye
E08.3531 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
E08.3532 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
E08.3533 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E08.3541 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
E08.3542 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
E08.3543 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E08.3551 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, right eye
E08.3552 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, left eye
E08.3553 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, bilateral
E08.3591 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, right eye
E08.3592 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, left eye
E08.3593 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, bilateral
E08.37X1 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, right eye
E08.37X2 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, left eye
E08.37X3 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, bilateral
E09.311 Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy with macular edema
E09.319 Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy without macular edema
E09.3211 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
E09.3212 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
E09.3213 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E09.3291 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
E09.3292 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
E09.3293 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E09.3311 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
E09.3312 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
E09.3313 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E09.3391 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
E09.3392 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
E09.3393 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E09.3411 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
E09.3412 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
E09.3413 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E09.3491 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
E09.3492 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
E09.3493 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E09.3511 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
E09.3512 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
E09.3513 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
E09.3521 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
E09.3522 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
E09.3523 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E09.3531 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
E09.3532 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
E09.3533 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E09.3541 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
E09.3542 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
E09.3543 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E09.3551 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, right eye
E09.3552 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, left eye
E09.3553 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
E09.3591 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
E09.3592 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
E09.3593 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
E09.37X1 Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, right eye
E09.37X2 Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, left eye
E09.37X3 Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
E09.37X9 Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye
E10.311 Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema
E10.319 Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema
E10.3211 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
E10.3212 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
E10.3213 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E10.3291 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
E10.3292 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
E10.3293 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E10.3311 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
E10.3312 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
E10.3313 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E10.3391 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
E10.3392 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
E10.3393 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E10.3411 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
E10.3412 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
E10.3413 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E10.3491 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
E10.3492 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
E10.3493 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E10.3511 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
E10.3512 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
E10.3513 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
E10.3521 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
E10.3522 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
E10.3523 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E10.3531 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
E10.3532 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
E10.3533 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E10.3541 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
E10.3542 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
E10.3543 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E10.3551 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, right eye
E10.3552 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, left eye
E10.3553 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
E10.3591 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
E10.3592 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
E10.3593 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
E10.37X1 Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye
E10.37X2 Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, left eye
E10.37X3 Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
E11.311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema
E11.319 Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema
E11.3211 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
E11.3212 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
E11.3213 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E11.3291 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
E11.3292 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
E11.3293 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E11.3311 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
E11.3312 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
E11.3313 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E11.3391 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
E11.3392 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
E11.3393 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E11.3411 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
E11.3412 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
E11.3413 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E11.3491 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
E11.3492 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
E11.3493 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E11.3511 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
E11.3512 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
E11.3513 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
E11.3521 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
E11.3522 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
E11.3523 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E11.3531 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
E11.3532 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
E11.3533 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E11.3541 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
E11.3542 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
E11.3543 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E11.3551 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, right eye
E11.3552 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left eye
E11.3553 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
E11.3591 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
E11.3592 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
E11.3593 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
E11.37X1 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye
E11.37X2 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, left eye
E11.37X3 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
E13.311 Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema
E13.319 Other specified diabetes mellitus with unspecified diabetic retinopathy without macular edema
E13.3211 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
E13.3212 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
E13.3213 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E13.3291 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
E13.3292 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
E13.3293 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E13.3311 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
E13.3312 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
E13.3313 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E13.3391 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
E13.3392 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
E13.3393 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E13.3411 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
E13.3412 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
E13.3413 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E13.3491 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
E13.3492 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
E13.3493 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E13.3511 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
E13.3512 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
E13.3513 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
E13.3521 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
E13.3522 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
E13.3523 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E13.3531 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
E13.3532 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
E13.3533 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E13.3541 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
E13.3542 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
E13.3543 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E13.3551 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, right eye
E13.3552 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, left eye
E13.3553 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
E13.3591 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
E13.3592 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
E13.3593 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
E13.37X1 Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, right eye
E13.37X2 Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, left eye
E13.37X3 Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
G45.3 Amaurosis fugax
H20.041 Secondary noninfectious iridocyclitis, right eye
H20.042 Secondary noninfectious iridocyclitis, left eye
H20.043 Secondary noninfectious iridocyclitis, bilateral
H30.001 Unspecified focal chorioretinal inflammation, right eye
H30.002 Unspecified focal chorioretinal inflammation, left eye
H30.003 Unspecified focal chorioretinal inflammation, bilateral
H30.011 Focal chorioretinal inflammation, juxtapapillary, right eye
H30.012 Focal chorioretinal inflammation, juxtapapillary, left eye
H30.013 Focal chorioretinal inflammation, juxtapapillary, bilateral
H30.021 Focal chorioretinal inflammation of posterior pole, right eye
H30.022 Focal chorioretinal inflammation of posterior pole, left eye
H30.023 Focal chorioretinal inflammation of posterior pole, bilateral
H30.031 Focal chorioretinal inflammation, peripheral, right eye
H30.032 Focal chorioretinal inflammation, peripheral, left eye
H30.033 Focal chorioretinal inflammation, peripheral, bilateral
H30.041 Focal chorioretinal inflammation, macular or paramacular, right eye
H30.042 Focal chorioretinal inflammation, macular or paramacular, left eye
H30.043 Focal chorioretinal inflammation, macular or paramacular, bilateral
H30.101 Unspecified disseminated chorioretinal inflammation, right eye
H30.102 Unspecified disseminated chorioretinal inflammation, left eye
H30.103 Unspecified disseminated chorioretinal inflammation, bilateral
H30.111 Disseminated chorioretinal inflammation of posterior pole, right eye
H30.112 Disseminated chorioretinal inflammation of posterior pole, left eye
H30.113 Disseminated chorioretinal inflammation of posterior pole, bilateral
H30.121 Disseminated chorioretinal inflammation, peripheral right eye
H30.122 Disseminated chorioretinal inflammation, peripheral, left eye
H30.123 Disseminated chorioretinal inflammation, peripheral, bilateral
H30.131 Disseminated chorioretinal inflammation, generalized, right eye
H30.132 Disseminated chorioretinal inflammation, generalized, left eye
H30.133 Disseminated chorioretinal inflammation, generalized, bilateral
H30.141 Acute posterior multifocal placoid pigment epitheliopathy, right eye
H30.142 Acute posterior multifocal placoid pigment epitheliopathy, left eye
H30.143 Acute posterior multifocal placoid pigment epitheliopathy, bilateral
H30.21 Posterior cyclitis, right eye
H30.22 Posterior cyclitis, left eye
H30.23 Posterior cyclitis, bilateral
H30.811 Harada's disease, right eye
H30.812 Harada's disease, left eye
H30.813 Harada's disease, bilateral
H30.891 Other chorioretinal inflammations, right eye
H30.892 Other chorioretinal inflammations, left eye
H30.893 Other chorioretinal inflammations, bilateral
H30.91 Unspecified chorioretinal inflammation, right eye
H30.92 Unspecified chorioretinal inflammation, left eye
H30.93 Unspecified chorioretinal inflammation, bilateral
H31.101 Choroidal degeneration, unspecified, right eye
H31.102 Choroidal degeneration, unspecified, left eye
H31.103 Choroidal degeneration, unspecified, bilateral
H31.111 Age-related choroidal atrophy, right eye
H31.112 Age-related choroidal atrophy, left eye
H31.113 Age-related choroidal atrophy, bilateral
H31.121 Diffuse secondary atrophy of choroid, right eye
H31.122 Diffuse secondary atrophy of choroid, left eye
H31.123 Diffuse secondary atrophy of choroid, bilateral
H32 Chorioretinal disorders in diseases classified elsewhere
H33.001 Unspecified retinal detachment with retinal break, right eye
H33.002 Unspecified retinal detachment with retinal break, left eye
H33.003 Unspecified retinal detachment with retinal break, bilateral
H33.011 Retinal detachment with single break, right eye
H33.012 Retinal detachment with single break, left eye
H33.013 Retinal detachment with single break, bilateral
H33.021 Retinal detachment with multiple breaks, right eye
H33.022 Retinal detachment with multiple breaks, left eye
H33.023 Retinal detachment with multiple breaks, bilateral
H33.031 Retinal detachment with giant retinal tear, right eye
H33.032 Retinal detachment with giant retinal tear, left eye
H33.033 Retinal detachment with giant retinal tear, bilateral
H33.051 Total retinal detachment, right eye
H33.052 Total retinal detachment, left eye
H33.053 Total retinal detachment, bilateral
H33.101 Unspecified retinoschisis, right eye
H33.102 Unspecified retinoschisis, left eye
H33.103 Unspecified retinoschisis, bilateral
H33.111 Cyst of ora serrata, right eye
H33.112 Cyst of ora serrata, left eye
H33.113 Cyst of ora serrata, bilateral
H33.191 Other retinoschisis and retinal cysts, right eye
H33.192 Other retinoschisis and retinal cysts, left eye
H33.193 Other retinoschisis and retinal cysts, bilateral
H33.21 Serous retinal detachment, right eye
H33.22 Serous retinal detachment, left eye
H33.23 Serous retinal detachment, bilateral
H33.301 Unspecified retinal break, right eye
H33.302 Unspecified retinal break, left eye
H33.303 Unspecified retinal break, bilateral
H33.311 Horseshoe tear of retina without detachment, right eye
H33.312 Horseshoe tear of retina without detachment, left eye
H33.313 Horseshoe tear of retina without detachment, bilateral
H33.321 Round hole, right eye
H33.322 Round hole, left eye
H33.323 Round hole, bilateral
H33.331 Multiple defects of retina without detachment, right eye
H33.332 Multiple defects of retina without detachment, left eye
H33.333 Multiple defects of retina without detachment, bilateral
H33.41 Traction detachment of retina, right eye
H33.42 Traction detachment of retina, left eye
H33.43 Traction detachment of retina, bilateral
H33.8 Other retinal detachments
H34.01 Transient retinal artery occlusion, right eye
H34.02 Transient retinal artery occlusion, left eye
H34.03 Transient retinal artery occlusion, bilateral
H34.11 Central retinal artery occlusion, right eye
H34.12 Central retinal artery occlusion, left eye
H34.13 Central retinal artery occlusion, bilateral
H34.231 Retinal artery branch occlusion, right eye
H34.232 Retinal artery branch occlusion, left eye
H34.233 Retinal artery branch occlusion, bilateral
H34.8110 Central retinal vein occlusion, right eye, with macular edema
H34.8111 Central retinal vein occlusion, right eye, with retinal neovascularization
H34.8112 Central retinal vein occlusion, right eye, stable
H34.8120 Central retinal vein occlusion, left eye, with macular edema
H34.8121 Central retinal vein occlusion, left eye, with retinal neovascularization
H34.8122 Central retinal vein occlusion, left eye, stable
H34.8130 Central retinal vein occlusion, bilateral, with macular edema
H34.8131 Central retinal vein occlusion, bilateral, with retinal neovascularization
H34.8132 Central retinal vein occlusion, bilateral, stable
H34.821 Venous engorgement, right eye
H34.822 Venous engorgement, left eye
H34.823 Venous engorgement, bilateral
H34.8310 Tributary (branch) retinal vein occlusion, right eye, with macular edema
H34.8311 Tributary (branch) retinal vein occlusion, right eye, with retinal neovascularization
H34.8312 Tributary (branch) retinal vein occlusion, right eye, stable
H34.8320 Tributary (branch) retinal vein occlusion, left eye, with macular edema
H34.8321 Tributary (branch) retinal vein occlusion, left eye, with retinal neovascularization
H34.8322 Tributary (branch) retinal vein occlusion, left eye, stable
H34.8330 Tributary (branch) retinal vein occlusion, bilateral, with macular edema
H34.8331 Tributary (branch) retinal vein occlusion, bilateral, with retinal neovascularization
H34.8332 Tributary (branch) retinal vein occlusion, bilateral, stable
H34.9 Unspecified retinal vascular occlusion
H35.00 Unspecified background retinopathy
H35.011 Changes in retinal vascular appearance, right eye
H35.012 Changes in retinal vascular appearance, left eye
H35.013 Changes in retinal vascular appearance, bilateral
H35.021 Exudative retinopathy, right eye
H35.022 Exudative retinopathy, left eye
H35.023 Exudative retinopathy, bilateral
H35.031 Hypertensive retinopathy, right eye
H35.032 Hypertensive retinopathy, left eye
H35.033 Hypertensive retinopathy, bilateral
H35.041 Retinal micro-aneurysms, unspecified, right eye
H35.042 Retinal micro-aneurysms, unspecified, left eye
H35.043 Retinal micro-aneurysms, unspecified, bilateral
H35.051 Retinal neovascularization, unspecified, right eye
H35.052 Retinal neovascularization, unspecified, left eye
H35.053 Retinal neovascularization, unspecified, bilateral
H35.061 Retinal vasculitis, right eye
H35.062 Retinal vasculitis, left eye
H35.063 Retinal vasculitis, bilateral
H35.071 Retinal telangiectasis, right eye
H35.072 Retinal telangiectasis, left eye
H35.073 Retinal telangiectasis, bilateral
H35.09 Other intraretinal microvascular abnormalities
H35.171 Retrolental fibroplasia, right eye
H35.172 Retrolental fibroplasia, left eye
H35.173 Retrolental fibroplasia, bilateral
H35.21 Other non-diabetic proliferative retinopathy, right eye
H35.22 Other non-diabetic proliferative retinopathy, left eye
H35.23 Other non-diabetic proliferative retinopathy, bilateral
H35.30 Unspecified macular degeneration
H35.3110 Nonexudative age-related macular degeneration, right eye, stage unspecified
H35.3111 Nonexudative age-related macular degeneration, right eye, early dry stage
H35.3112 Nonexudative age-related macular degeneration, right eye, intermediate dry stage
H35.3113 Nonexudative age-related macular degeneration, right eye, advanced atrophic without subfoveal involvement
H35.3114 Nonexudative age-related macular degeneration, right eye, advanced atrophic with subfoveal involvement
H35.3120 Nonexudative age-related macular degeneration, left eye, stage unspecified
H35.3121 Nonexudative age-related macular degeneration, left eye, early dry stage
H35.3122 Nonexudative age-related macular degeneration, left eye, intermediate dry stage
H35.3123 Nonexudative age-related macular degeneration, left eye, advanced atrophic without subfoveal involvement
H35.3124 Nonexudative age-related macular degeneration, left eye, advanced atrophic with subfoveal involvement
H35.3130 Nonexudative age-related macular degeneration, bilateral, stage unspecified
H35.3131 Nonexudative age-related macular degeneration, bilateral, early dry stage
H35.3132 Nonexudative age-related macular degeneration, bilateral, intermediate dry stage
H35.3133 Nonexudative age-related macular degeneration, bilateral, advanced atrophic without subfoveal involvement
H35.3134 Nonexudative age-related macular degeneration, bilateral, advanced atrophic with subfoveal involvement
H35.3210 Exudative age-related macular degeneration, right eye, stage unspecified
H35.3211 Exudative age-related macular degeneration, right eye, with active choroidal neovascularization
H35.3212 Exudative age-related macular degeneration, right eye, with inactive choroidal neovascularization
H35.3213 Exudative age-related macular degeneration, right eye, with inactive scar
H35.3220 Exudative age-related macular degeneration, left eye, stage unspecified
H35.3221 Exudative age-related macular degeneration, left eye, with active choroidal neovascularization
H35.3222 Exudative age-related macular degeneration, left eye, with inactive choroidal neovascularization
H35.3223 Exudative age-related macular degeneration, left eye, with inactive scar
H35.3230 Exudative age-related macular degeneration, bilateral, stage unspecified
H35.3231 Exudative age-related macular degeneration, bilateral, with active choroidal neovascularization
H35.3232 Exudative age-related macular degeneration, bilateral, with inactive choroidal neovascularization
H35.3233 Exudative age-related macular degeneration, bilateral, with inactive scar
H35.33 Angioid streaks of macula
H35.341 Macular cyst, hole, or pseudohole, right eye
H35.342 Macular cyst, hole, or pseudohole, left eye
H35.343 Macular cyst, hole, or pseudohole, bilateral
H35.351 Cystoid macular degeneration, right eye
H35.352 Cystoid macular degeneration, left eye
H35.353 Cystoid macular degeneration, bilateral
H35.361 Drusen (degenerative) of macula, right eye
H35.362 Drusen (degenerative) of macula, left eye
H35.363 Drusen (degenerative) of macula, bilateral
H35.371 Puckering of macula, right eye
H35.372 Puckering of macula, left eye
H35.373 Puckering of macula, bilateral
H35.381 Toxic maculopathy, right eye
H35.382 Toxic maculopathy, left eye
H35.383 Toxic maculopathy, bilateral
H35.40 Unspecified peripheral retinal degeneration
H35.461 Secondary vitreoretinal degeneration, right eye
H35.462 Secondary vitreoretinal degeneration, left eye
H35.463 Secondary vitreoretinal degeneration, bilateral
H35.50 Unspecified hereditary retinal dystrophy
H35.51 Vitreoretinal dystrophy
H35.52 Pigmentary retinal dystrophy
H35.53 Other dystrophies primarily involving the sensory retina
H35.54 Dystrophies primarily involving the retinal pigment epithelium
H35.61 Retinal hemorrhage, right eye
H35.62 Retinal hemorrhage, left eye
H35.63 Retinal hemorrhage, bilateral
H35.70 Unspecified separation of retinal layers
H35.711 Central serous chorioretinopathy, right eye
H35.712 Central serous chorioretinopathy, left eye
H35.713 Central serous chorioretinopathy, bilateral
H35.721 Serous detachment of retinal pigment epithelium, right eye
H35.722 Serous detachment of retinal pigment epithelium, left eye
H35.723 Serous detachment of retinal pigment epithelium, bilateral
H35.731 Hemorrhagic detachment of retinal pigment epithelium, right eye
H35.732 Hemorrhagic detachment of retinal pigment epithelium, left eye
H35.733 Hemorrhagic detachment of retinal pigment epithelium, bilateral
H35.81 Retinal edema
H35.82 Retinal ischemia
H35.89 Other specified retinal disorders
H36.89 Other retinal disorders in diseases classified elsewhere
H43.821 Vitreomacular adhesion, right eye
H43.822 Vitreomacular adhesion, left eye
H43.823 Vitreomacular adhesion, bilateral
H44.2A1 Degenerative myopia with choroidal neovascularization, right eye
H44.2A2 Degenerative myopia with choroidal neovascularization, left eye
H44.2A3 Degenerative myopia with choroidal neovascularization, bilateral
H44.2B1 Degenerative myopia with macular hole, right eye
H44.2B2 Degenerative myopia with macular hole, left eye
H44.2B3 Degenerative myopia with macular hole, bilateral
H59.031 Cystoid macular edema following cataract surgery, right eye
H59.032 Cystoid macular edema following cataract surgery, left eye
H59.033 Cystoid macular edema following cataract surgery, bilateral
Z03.6 Encounter for observation for suspected toxic effect from ingested substance ruled out
Z03.89 Encounter for observation for other suspected diseases and conditions ruled out
Z09 Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm
Z79.899 Other long term (current) drug therapy
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ICD-10-CM Codes that DO NOT Support Medical Necessity

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ICD-10-PCS Codes

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Bill Type Codes

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Revision History Information

Revision History Date Revision History Number Revision History Explanation
10/01/2024 R8

Posted 09/26/2024: Under ICD-10 Codes that Support Medical Necessity Group 3 Codes, description updates were made to H44.2A3 and H44.2B3. This is due to the 2025 annual ICD-10-CM code updates.

10/01/2023 R7

Posted 09/28/2023: Under ICD-10 Codes that Support Medical Necessity Group 3 Codes added ICD-10 code H36.89 and deleted ICD-10 code H36 due to the 2024 Annual ICD-10-CM Code Updates.

06/29/2023 R6

06/29/2023 Biannual review completed with no change in coverage.

09/30/2021 R5

09/30/2021 Review completed 08/31/2021 with no change in coverage. Punctuation corrections made and defined acronyms inserted where appropriate throughout the article.

10/29/2020 R4

10/29/2020 Group 3 ICD-10 Codes: Added H44.2B1, H44.2B2, and H44.2B3 due to a Provider’s request.

10/01/2020 R3

10/01/2020 ICD-10-CM Code Updates to Group 1: Deleted H18.50, H18.51, T86.840, T86.841,and T86.842 and added H18.501, H18.502, H18.503, H18.511, H18.512, H18.513, T86.8401, T86.8402, T86.8403, T86.8411, T86.8412, T86.8413, T86.8421, T86.8422, and T86.8423.

10/31/2019 R2

10/31/2019 Group 3 ICD-10 Codes: Added H44.2A1, H44.2A2, and H44.2A3 due to a Provider’s request.

08/29/2019 R1

09/26/2019 Group 2 ICD-10 Code: Added H40.10X4 to Coverage Table. ICD -10 Code was inadvertently removed during code migration. There will not be a lapse in coverage.

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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related National Coverage Documents
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SAD Process URL 1
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SAD Process URL 2
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CMS Manual Explanations URLs
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c32.pdf
Description: 100-04 Medicare Claims Processing Manual, Chapter 32 - Billing Requirements for Special Services, Section 300.2 for Claims Processing Requirements for OPT with Verteporfin Services on Professional
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