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LCD Reference Article Billing and Coding Article

Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging

A57600

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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
A57600
Original ICD-9 Article ID
Not Applicable
Article Title
Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging
Article Type
Billing and Coding
Original Effective Date
10/31/2019
Revision Effective Date
10/01/2024
Revision Ending Date
N/A
Retirement Date
N/A

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Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. The views and/or positions presented in the material do not necessarily represent the views of the AHA. CMS and its products and services are not endorsed by the AHA or any of its affiliates.

CMS National Coverage Policy

Internet Only Manual (IOM) Citations:

  • CMS IOM Publication 100-04, Medicare Claims Processing Manual,
    • Chapter 23 Fee Schedule Administration and Coding Requirements, Section 10 Reporting ICD Diagnosis and Procedure codes and Section 20.9 National Correct Coding Initiative (NCCI)

National Correct Coding Initiative (NCCI) Citation:

  • NCCI Policy Manual for Medicare Services,
    • Chapter XI Medicare Evaluation and Management Services CPT Codes 90000-99999, Section G, Ophthalmology.

Social Security Act (Title XVIII) Standard References:

  • Title XVIII of the Social Security Act, Section 1833(e) states that no payment shall be made to any provider of services or other person under this part unless there has been furnished such information as may be necessary in order to determine the amounts due such provider or other person under this part for the period with respect to which the amounts are being paid or for any prior period.

Article Guidance

Article Text

This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L35038, Scanning Computerized Ophthalmic Diagnostic Imaging. Please refer to the LCD for reasonable and necessary requirements and limitations.

Coding Guidance

Notice: It is not appropriate to bill Medicare for services that are not covered (as described by the entire LCD) as if they are covered. When billing for non-covered services, use the appropriate modifier.

Utilization Parameters

One month is defined as 28 days. No more than one (1) exam per month will be considered medically reasonable and necessary to manage the patient with retinal conditions undergoing active treatment.

CPT code 92132 and 92133 may not be reported more than two (2) times per year. Please refer to the LCD for details on reasonable and necessary guidelines.

CPT code 92134 may not be reported more than one (1) time every two (2) months. Please refer to the LCD for details on reasonable and necessary guidelines.

Documentation Requirements

  1. All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
  2. Every page of the record must be legible and include appropriate patient identification information (e.g., complete name, dates of service[s]). The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient.
  3. The submitted medical record must support the use of the selected ICD-10-CM code(s). The submitted CPT/HCPCS code must describe the service performed.

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Group 1

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 Group 1 Codes

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ICD-10-CM Codes that Support Medical Necessity

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Group 1

(99 Codes)
Group 1 Paragraph


It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim(s) submitted.

The following ICD-10-CM codes support medical necessity and provide coverage for CPT code: 92132 – anterior segment:

 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
C69.41 Malignant neoplasm of right ciliary body
C69.42 Malignant neoplasm of left ciliary body
H17.01 Adherent leukoma, right eye
H17.02 Adherent leukoma, left eye
H17.03 Adherent leukoma, bilateral
H17.11 Central corneal opacity, right eye
H17.12 Central corneal opacity, left eye
H17.13 Central corneal opacity, bilateral
H17.811 Minor opacity of cornea, right eye
H17.812 Minor opacity of cornea, left eye
H17.813 Minor opacity of cornea, bilateral
H17.821 Peripheral opacity of cornea, right eye
H17.822 Peripheral opacity of cornea, left eye
H17.823 Peripheral opacity of cornea, bilateral
H17.89 Other corneal scars and opacities
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
H21.221 Degeneration of ciliary body, right eye
H21.222 Degeneration of ciliary body, left eye
H21.223 Degeneration of ciliary body, bilateral
H21.231 Degeneration of iris (pigmentary), right eye
H21.232 Degeneration of iris (pigmentary), left eye
H21.233 Degeneration of iris (pigmentary), bilateral
H21.271 Miotic pupillary cyst, right eye
H21.272 Miotic pupillary cyst, left eye
H21.273 Miotic pupillary cyst, bilateral
H21.301 Idiopathic cysts of iris, ciliary body or anterior chamber, right eye
H21.302 Idiopathic cysts of iris, ciliary body or anterior chamber, left eye
H21.303 Idiopathic cysts of iris, ciliary body or anterior chamber, bilateral
H21.311 Exudative cysts of iris or anterior chamber, right eye
H21.312 Exudative cysts of iris or anterior chamber, left eye
H21.313 Exudative cysts of iris or anterior chamber, bilateral
H21.321 Implantation cysts of iris, ciliary body or anterior chamber, right eye
H21.322 Implantation cysts of iris, ciliary body or anterior chamber, left eye
H21.323 Implantation cysts of iris, ciliary body or anterior chamber, bilateral
H21.89 Other specified disorders of iris and ciliary body
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
H40.211 Acute angle-closure glaucoma, right eye
H40.212 Acute angle-closure glaucoma, left eye
H40.213 Acute angle-closure glaucoma, bilateral
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
H40.2221 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
H40.2231 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
H40.31X1 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
H40.32X1 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
H40.33X1 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
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

(199 Codes)
Group 2 Paragraph

It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim(s) submitted.

The following ICD-10-CM codes support medical necessity and provide coverage for CPT code: 92133 –optic nerve:

 Group 2 Codes
Code Description
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
H40.1111 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
H40.1121 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
H40.1131 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
H40.1211 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
H40.1221 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
H40.1231 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
H40.1311 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
H40.1321 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
H40.1331 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
H40.1411 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
H40.1421 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
H40.1431 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
H40.211 Acute angle-closure glaucoma, right eye
H40.212 Acute angle-closure glaucoma, left eye
H40.213 Acute angle-closure glaucoma, bilateral
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
H40.2221 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
H40.2231 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
H40.31X1 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
H40.32X1 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
H40.33X1 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
H40.41X1 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
H40.42X1 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
H40.43X1 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
H40.51X1 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
H40.52X1 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
H40.53X1 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
H40.61X1 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
H40.62X1 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
H40.63X1 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
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
H46.8 Other optic neuritis
H47.011 Ischemic optic neuropathy, right eye
H47.012 Ischemic optic neuropathy, left eye
H47.013 Ischemic optic neuropathy, bilateral
H47.031 Optic nerve hypoplasia, right eye
H47.032 Optic nerve hypoplasia, left eye
H47.033 Optic nerve hypoplasia, bilateral
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
H47.211 Primary optic atrophy, right eye
H47.212 Primary optic atrophy, left eye
H47.213 Primary optic atrophy, 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
H47.391 Other disorders of optic disc, right eye
H47.392 Other disorders of optic disc, left eye
H47.393 Other disorders of optic disc, bilateral
H53.15 Visual distortions of shape and size
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

(492 Codes)
Group 3 Paragraph

It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim(s) submitted.

The following ICD-10-CM codes support medical necessity and provide coverage for CPT code 92134 – retina:

 Group 3 Codes
Code Description
A18.53 Tuberculous chorioretinitis
B39.4 Histoplasmosis capsulati, unspecified
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
D31.31 Benign neoplasm of right choroid
D31.32 Benign neoplasm of left choroid
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
E08.3531 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
E09.3211 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
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
E11.3211 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
E13.3211 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
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
H30.111 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
H31.021 Solar retinopathy, right eye
H31.022 Solar retinopathy, left eye
H31.023 Solar retinopathy, 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
H31.21 Choroideremia
H31.22 Choroidal dystrophy (central areolar) (generalized) (peripapillary)
H31.23 Gyrate atrophy, choroid
H31.29 Other hereditary choroidal dystrophy
H31.411 Hemorrhagic choroidal detachment, right eye
H31.412 Hemorrhagic choroidal detachment, left eye
H31.413 Hemorrhagic choroidal detachment, bilateral
H31.421 Serous choroidal detachment, right eye
H31.422 Serous choroidal detachment, left eye
H31.423 Serous choroidal detachment, bilateral
H32 Chorioretinal disorders in diseases classified elsewhere
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
H33.041 Retinal detachment with retinal dialysis, right eye
H33.042 Retinal detachment with retinal dialysis, left eye
H33.043 Retinal detachment with retinal dialysis, bilateral
H33.051 Total retinal detachment, right eye
H33.052 Total retinal detachment, left eye
H33.053 Total retinal detachment, 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
H33.311 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
H34.211 Partial retinal artery occlusion, right eye
H34.212 Partial retinal artery occlusion, left eye
H34.213 Partial 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
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
H35.3110 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
H35.411 Lattice degeneration of retina, right eye
H35.412 Lattice degeneration of retina, left eye
H35.413 Lattice degeneration of retina, bilateral
H35.421 Microcystoid degeneration of retina, right eye
H35.422 Microcystoid degeneration of retina, left eye
H35.423 Microcystoid degeneration of retina, bilateral
H35.431 Paving stone degeneration of retina, right eye
H35.432 Paving stone degeneration of retina, left eye
H35.433 Paving stone degeneration of retina, bilateral
H35.441 Age-related reticular degeneration of retina, right eye
H35.442 Age-related reticular degeneration of retina, left eye
H35.443 Age-related reticular degeneration of retina, bilateral
H35.451 Secondary pigmentary degeneration, right eye
H35.452 Secondary pigmentary degeneration, left eye
H35.453 Secondary pigmentary degeneration, bilateral
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
H40.831 Aqueous misdirection, right eye
H40.832 Aqueous misdirection, left eye
H40.833 Aqueous misdirection, bilateral
H40.89 Other specified glaucoma
H43.811 Vitreous degeneration, right eye
H43.812 Vitreous degeneration, left eye
H43.813 Vitreous degeneration, bilateral
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
H44.2C1 Degenerative myopia with retinal detachment, right eye
H44.2C2 Degenerative myopia with retinal detachment, left eye
H44.2C3 Degenerative myopia with retinal detachment, bilateral
H44.2D1 Degenerative myopia with foveoschisis, right eye
H44.2D2 Degenerative myopia with foveoschisis, left eye
H44.2D3 Degenerative myopia with foveoschisis, bilateral
H44.2E1 Degenerative myopia with other maculopathy, right eye
H44.2E2 Degenerative myopia with other maculopathy, left eye
H44.2E3 Degenerative myopia with other maculopathy, bilateral
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
H53.15 Visual distortions of shape and size
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
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
Z79.899* Other long term (current) drug therapy
Group 3 Medical Necessity ICD-10-CM Codes Asterisk Explanation

*Note: Z79.899 is to be reported for the baseline evaluation and for annual monitoring of patients on chloroquine (CQ) and/or hydroxychloroquine (HCQ).
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ICD-10-CM Codes that DO NOT Support Medical Necessity

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Group 1

Group 1 Paragraph

All those not listed under the “ICD-10 Codes that Support Medical Necessity” section of this article.

 Group 1 Codes

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ICD-10-PCS Codes

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Group 1

Group 1 Paragraph

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 Group 1 Codes

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Additional ICD-10 Information

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Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

Code Description

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Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

Code Description

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Other Coding Information

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Group 1

Group 1 Paragraph

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 Group 1 Codes

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Coding Table Information

Excluded CPT/HCPCS Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
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Non-Excluded CPT/HCPCS Ended Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
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Revision History Information

Revision History Date Revision History Number Revision History Explanation
10/01/2024 R4

Article revised and published on 10/24/2024 effective for dates of service on and after 10/01/2024 to reflect the Annual ICD-10-CM Code Updates. The description has changed for the following ICD-10-CM codes in Code Group 3: H44.2A3, H44.2B3, H44.2C3, H44.2D3 and H44.2E3.
08/06/2021 R3

Article revised and published on 10/28/2021 effective for dates of service on and after 8/6/2021 as the result of an appeal. The following ICD10 codes have been added: H31.21, H31.22, H31.23, and H31.29 to Group 3.

The providers responsibilities were added to ‘Group 2 Paragraph’ and ‘Group 3 Paragraph’ under the ICD-10-CM Codes that Support Medical Necessity, along with general formatting changes throughout the article.
01/07/2021 R2

This Local Coverage Billing and Coding Article (LCA) displayed on 01/07/2021 and effective for dates of service on and after 01/07/2021 was revised to include the additional clarifying language: “One month is defined as 28 days. No more than one (1) exam per month will be considered medically reasonable and necessary to manage the patient with retinal conditions undergoing active treatment. “, in the “Utilization Parameters” section of this LCA. Also, formatting and typographical changes throughout.
10/01/2020 R1

Article revised and published effective for dates of service on and after 10/01/2020 in response to the Annual 2021 ICD-10-CM Update. ICD-10 Codes T86.840, T86.841, and T86.842 are deleted from the ICD-10 Codes that Support Medical Necessity/Group 1 Codes:” section of this billing and coding article and ICD-10 Codes T86.8401, T86.8402, T86.8403, T86.8411, T86.8412, T86.8413, T86.8421, T86.8422, and T86.8423 are to be added to the“ICD-10 Codes that Support Medical Necessity/Group 1 Codes:” section of this billing and coding article.
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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
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Updated On Effective Dates Status
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10/22/2021 08/06/2021 - 09/30/2024 Superseded View
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