LCD Reference Article Billing and Coding Article

Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)

A56726

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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
A56726
Original ICD-9 Article ID
Not Applicable
Article Title
Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
Article Type
Billing and Coding
Original Effective Date
08/01/2019
Revision Effective Date
10/01/2024
Revision Ending Date
N/A
Retirement Date
N/A

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CMS National Coverage Policy

Language quoted from Centers for Medicare and Medicaid Services (CMS), National Coverage Determinations (NCDs) and coverage provisions in interpretive manuals is italicized throughout the policy. NCDs and coverage provisions in interpretive manuals are not subject to the Local Coverage Determination (LCD) Review Process (42 CFR 405.860[b] and 42 CFR 426 [Subpart D]). In addition, an administrative law judge may not review an NCD. See §1869(f)(1)(A)(i) of the Social Security Act.

Unless otherwise specified, italicized text represents quotation from one or more of the following CMS sources:

Title XVIII of the Social Security Act (SSA):

Section 1862(a)(1)(A) excludes expenses incurred for items or services which are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.

Section 1833(e) prohibits Medicare payment for any claim which lacks the necessary information to process the claim.

Section 1862(a) (7) excludes routine physical examination unless otherwise covered by statute.

Code of Federal Regulations:

42 CFR Section 410.32 indicates that diagnostic tests may only be ordered by the treating physician (or other treating practitioner acting within the scope of his or her license and Medicare requirements) who furnishes a consultation or treats a beneficiary for a specific medical problem and who uses the results in the management of the beneficiary's specific medical problem. Tests not ordered by the physician (or other qualified non-physician provider) who is treating the beneficiary are not reasonable and necessary (see Sec. 411.15(k)(1) of this chapter).

CMS Publications:

CMS Publication 100-04, Medicare Claims Manual, Chapter 12:

    40.1.A. Global surgery period

 

Article Guidance

Article Text

This article contains coding and other guidelines that complement the local coverage determination (LCD) for Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography).

Coding Information:

Procedure codes may be subject to National Correct Coding Initiative (NCCI) edits or OPPS packaging edits. Refer to NCCI and OPPS requirements prior to billing Medicare.

For services requiring a referring/ordering physician, the name and NPI of the referring/ordering physician must be reported on the claim.

A claim submitted without a valid ICD-10-CM diagnosis code will be returned to the provider as an incomplete claim under Section 1833(e) of the Social Security Act.

The diagnosis code(s) must best describe the patient's condition for which the service was performed.

Documentation Requirements:

Fundus photography
The patient's medical record must contain documentation that fully supports the medical necessity for fundus photography as it is covered by Medicare. This documentation includes, but is not limited to, relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.

A copy of the fundus photographs must be retained in the patient's medical records. An interpretation and report of the test must also be included, in addition to the photographs themselves.

The medical record should document whether the pupil was dilated, and which drug was used.

Documentation supporting the medical necessity should be legible, maintained in the patient's record, and must be available to the carrier upon request.

Extended ophthalmoscopy
The patient's medical record must contain documentation that fully supports the medical necessity for extended ophthalmoscopy for each eye, as it is covered by Medicare. This documentation includes, but is not limited to, relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.

Retinal drawings meeting the specifications indicated in the attached Appendix A of this article must be maintained in the patient's record.

  • There must be a separate detailed sketch, minimal size of 3-4 inches.
  • All items noted must be identified and labeled.
  • Drawings in four (4) - six (6) standard colors are preferred. However, non-colored drawings are also acceptable, if clearly labeled.
  • Optic nerve abnormalities should be separately drawn.
  • An extensive scaled drawing must accurately represent normal, abnormal and common findings such as: lattice degeneration, hypertensive vascular changes, proliferative diabetic retinopathy, as well as retinal detachments, holes, tears or tumors.
  • Documentation in the patient’s medical record for a diagnosis of glaucoma (ICD-10-CM codes H40.001-H40.152 Glaucoma ) must include all of the following:
    • A separate detailed drawing of the optic nerve along with an interpretation that affects the plan of treatment,
    • Documentation of cupping, disc rim, pallor, and slope,
    • Documentation of any surrounding pathology around the optic nerve.
    • Documentation specific to the method of examination (e.g., lens, scleral depression, instrument used) should be maintained in the medical record.

The medical record should document whether the pupil was dilated, and which drug was used.

All findings and a plan of action should be documented in notes.

Although routine ophthalmoscopy and biomicroscopy are part of an ophthalmologic examination and are not separately payable, these should still be documented in the patient's medical record.

Documentation supporting the medical necessity should be legible, maintained in the patient's record, and must be available to the carrier upon request.

Appendices:

See attachment in LCD L33567

Utilization Guidelines:

Patients actively being treated with intravitreal injections of medication for exudative AMD (ICD-10-CM code ranges H35.3210-H35.3213, H35.3220-H35.3223, H35.3230- H35.3233) may require up to 12 extended ophthalmoscopies per eye, per year.

Conditions coded with other ICD-10-CM codes in the ranges A18.53; A18.54; E08.311-E08.359 Diabetes mellitus due to underlying condition with ophthalmic complications E09.311-E09.359 Drug or chemical induced diabetes mellitus with ophthalmic complications;E10.311-E10.359 Type 1 diabetes mellitus with ophthalmic complications; E11.311-E11.359 Type 2 diabetes mellitus with ophthalmic complications; E13.311-E13.359 Other specified diabetes mellitus with ophthalmic complications; H16.241-H16.249 Ophthalmia nodosa; H20.00-H21.1X1; G45.3 Diseases of the eye and adnexa may require up to six (6) extended ophthalmoscopic examinations per eye, per year.

For ICD-10-CM codes C69.20-C69.42 Malignant neoplasm of eye and adnexa; C79.89-C79.9 Secondary malignant neoplasm of other and unspecified sites; D31.20-D31.32 Benign neoplasm of eye and adnexa up to four (4) extended ophthalmoscopic examinations may be required per eye, per year.

Other conditions usually require no more than two (2) extended ophthalmoscopic examinations per eye, per year.

Extended ophthalmoscopy is a physician service (examination of the eye) commonly occurring during the global post-operative period of ophthalmic surgery. As a physician service, it is included in the aftercare of the patient and is not separately billable.

Fundus photography is usually medically necessary no more than two times per year.

Fundus photography of a normal retina will be considered not medically necessary.

Services exceeding these parameters will be considered not medically necessary.

 

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ICD-10-CM Codes that Support Medical Necessity

Group 1

(1,078 Codes)
Group 1 Paragraph

ICD-10-CM codes for fundus photography and extended ophthalmoscopy (CPT codes 92201, 92202, 92228, 92250)

Group 1 Codes
Code Description
A18.53 Tuberculous chorioretinitis
B39.4 Histoplasmosis capsulati, unspecified
B39.5 Histoplasmosis duboisii
B39.9 Histoplasmosis, unspecified
B58.01 Toxoplasma chorioretinitis
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
C72.31 Malignant neoplasm of right optic nerve
C72.32 Malignant neoplasm of left optic nerve
C72.59 Malignant neoplasm of other cranial nerves
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
D33.3 Benign neoplasm of cranial nerves
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 - E08.3213 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, right eye - Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E08.3291 - E08.3293 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, right eye - Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E08.3311 - E08.3313 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, right eye - Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E08.3391 - E08.3393 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, right eye - Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E08.3411 - E08.3413 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, right eye - Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E08.3491 - E08.3493 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, right eye - Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E08.3511 - E08.3513 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, right eye - Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, bilateral
E08.3521 - E08.3523 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye - Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E08.3531 - E08.3533 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye - Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E08.3541 - E08.3543 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye - Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E08.3551 - E08.3553 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, right eye - Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, bilateral
E08.3591 - E08.3593 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, right eye - Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, bilateral
E08.36 Diabetes mellitus due to underlying condition with diabetic cataract
E08.37X1 - E08.37X3 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, right eye - Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, bilateral
E08.39 Diabetes mellitus due to underlying condition with other diabetic ophthalmic complication
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 - E09.3213 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye - Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E09.3291 - E09.3293 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye - Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E09.3311 - E09.3313 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye - Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E09.3391 - E09.3393 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye - Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E09.3411 - E09.3413 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye - Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E09.3491 - E09.3493 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye - Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E09.3511 - E09.3513 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye - Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
E09.3521 - E09.3523 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye - Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E09.3531 - E09.3533 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye - Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E09.3541 - E09.3543 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye - Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E09.3551 - E09.3553 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, right eye - Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
E09.3591 - E09.3593 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye - Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
E09.36 Drug or chemical induced diabetes mellitus with diabetic cataract
E09.37X1 - E09.37X3 Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, right eye - Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
E09.39 Drug or chemical induced diabetes mellitus with other diabetic ophthalmic complication
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 - E10.3213 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye - Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E10.3291 - E10.3293 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye - Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E10.3311 - E10.3313 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye - Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E10.3391 - E10.3393 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye - Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E10.3411 - E10.3413 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye - Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E10.3491 - E10.3493 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye - Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E10.3511 - E10.3513 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye - Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
E10.3521 - E10.3523 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye - Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E10.3531 - E10.3533 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye - Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E10.3541 - E10.3543 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye - Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E10.3551 - E10.3553 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, right eye - Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
E10.3591 - E10.3593 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye - Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
E10.36 Type 1 diabetes mellitus with diabetic cataract
E10.37X1 - E10.37X3 Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye - Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
E10.39 Type 1 diabetes mellitus with other diabetic ophthalmic complication
E10.65 Type 1 diabetes mellitus with hyperglycemia
E10.9 Type 1 diabetes mellitus without complications
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 - E11.3213 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye - Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E11.3291 - E11.3293 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye - Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E11.3311 - E11.3313 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye - Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E11.3391 - E11.3393 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye - Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E11.3411 - E11.3413 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye - Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E11.3491 - E11.3493 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye - Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E11.3511 - E11.3513 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye - Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
E11.3521 - E11.3523 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye - Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E11.3531 - E11.3533 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye - Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E11.3541 - E11.3543 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye - Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E11.3551 - E11.3553 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, right eye - Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
E11.3591 - E11.3593 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye - Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
E11.36 Type 2 diabetes mellitus with diabetic cataract
E11.37X1 - E11.37X3 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye - Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
E11.39 Type 2 diabetes mellitus with other diabetic ophthalmic complication
E11.65 Type 2 diabetes mellitus with hyperglycemia
E11.9 Type 2 diabetes mellitus without complications
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 - E13.3213 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye - Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E13.3291 - E13.3293 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye - Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E13.3311 - E13.3313 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye - Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E13.3391 - E13.3393 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye - Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E13.3411 - E13.3413 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye - Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E13.3491 - E13.3493 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye - Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E13.3511 - E13.3513 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye - Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
E13.3521 - E13.3523 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye - Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E13.3531 - E13.3533 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye - Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E13.3541 - E13.3543 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye - Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E13.3551 - E13.3553 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, right eye - Other specified diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
E13.3591 - E13.3593 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye - Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
E13.36 Other specified diabetes mellitus with diabetic cataract
E13.37X1 - E13.37X3 Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, right eye - Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
E13.39 Other specified diabetes mellitus with other diabetic ophthalmic complication
G45.3 Amaurosis fugax
H15.031 Posterior scleritis, right eye
H15.032 Posterior scleritis, left eye
H15.033 Posterior scleritis, bilateral
H16.241 Ophthalmia nodosa, right eye
H16.242 Ophthalmia nodosa, left eye
H16.243 Ophthalmia nodosa, bilateral
H20.821 Vogt-Koyanagi syndrome, right eye
H20.822 Vogt-Koyanagi syndrome, left eye
H20.823 Vogt-Koyanagi syndrome, bilateral
H21.331 Parasitic cyst of iris, ciliary body or anterior chamber, right eye
H21.332 Parasitic cyst of iris, ciliary body or anterior chamber, left eye
H21.333 Parasitic cyst of iris, ciliary body or anterior chamber, bilateral
H21.82 Plateau iris syndrome (post-iridectomy) (postprocedural)
H27.111 Subluxation of lens, right eye
H27.112 Subluxation of lens, left eye
H27.113 Subluxation of lens, bilateral
H27.131 Posterior dislocation of lens, right eye
H27.132 Posterior dislocation of lens, left eye
H27.133 Posterior dislocation of lens, 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
H30.111 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
H31.001 Unspecified chorioretinal scars, right eye
H31.002 Unspecified chorioretinal scars, left eye
H31.003 Unspecified chorioretinal scars, bilateral
H31.011 Macula scars of posterior pole (postinflammatory) (post-traumatic), right eye
H31.012 Macula scars of posterior pole (postinflammatory) (post-traumatic), left eye
H31.013 Macula scars of posterior pole (postinflammatory) (post-traumatic), bilateral
H31.021 Solar retinopathy, right eye
H31.022 Solar retinopathy, left eye
H31.023 Solar retinopathy, bilateral
H31.091 Other chorioretinal scars, right eye
H31.092 Other chorioretinal scars, left eye
H31.093 Other chorioretinal scars, 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
H31.20 Hereditary choroidal dystrophy, unspecified
H31.21 Choroideremia
H31.22 Choroidal dystrophy (central areolar) (generalized) (peripapillary)
H31.23 Gyrate atrophy, choroid
H31.29 Other hereditary choroidal dystrophy
H31.301 Unspecified choroidal hemorrhage, right eye
H31.302 Unspecified choroidal hemorrhage, left eye
H31.303 Unspecified choroidal hemorrhage, bilateral
H31.311 Expulsive choroidal hemorrhage, right eye
H31.312 Expulsive choroidal hemorrhage, left eye
H31.313 Expulsive choroidal hemorrhage, bilateral
H31.321 Choroidal rupture, right eye
H31.322 Choroidal rupture, left eye
H31.323 Choroidal rupture, bilateral
H31.401 Unspecified choroidal detachment, right eye
H31.402 Unspecified choroidal detachment, left eye
H31.403 Unspecified choroidal detachment, bilateral
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
H31.8 Other specified disorders of choroid
H31.9 Unspecified disorder of choroid
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
H33.041 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
H33.101 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
H33.121 Parasitic cyst of retina, right eye
H33.122 Parasitic cyst of retina, left eye
H33.123 Parasitic cyst of retina, 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
H34.211 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 - H34.8112 Central retinal vein occlusion, right eye, with macular edema - Central retinal vein occlusion, right eye, stable
H34.8120 - H34.8122 Central retinal vein occlusion, left eye, with macular edema - Central retinal vein occlusion, left eye, stable
H34.8130 - H34.8132 Central retinal vein occlusion, bilateral, with macular edema - 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 - H34.8312 Tributary (branch) retinal vein occlusion, right eye, with macular edema - Tributary (branch) retinal vein occlusion, right eye, stable
H34.8320 - H34.8322 Tributary (branch) retinal vein occlusion, left eye, with macular edema - Tributary (branch) retinal vein occlusion, left eye, stable
H34.8330 - H34.8332 Tributary (branch) retinal vein occlusion, bilateral, with macular edema - 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
H35.101 Retinopathy of prematurity, unspecified, right eye
H35.102 Retinopathy of prematurity, unspecified, left eye
H35.103 Retinopathy of prematurity, unspecified, bilateral
H35.111 Retinopathy of prematurity, stage 0, right eye
H35.112 Retinopathy of prematurity, stage 0, left eye
H35.113 Retinopathy of prematurity, stage 0, bilateral
H35.121 Retinopathy of prematurity, stage 1, right eye
H35.122 Retinopathy of prematurity, stage 1, left eye
H35.123 Retinopathy of prematurity, stage 1, bilateral
H35.131 Retinopathy of prematurity, stage 2, right eye
H35.132 Retinopathy of prematurity, stage 2, left eye
H35.133 Retinopathy of prematurity, stage 2, bilateral
H35.141 Retinopathy of prematurity, stage 3, right eye
H35.142 Retinopathy of prematurity, stage 3, left eye
H35.143 Retinopathy of prematurity, stage 3, bilateral
H35.151 Retinopathy of prematurity, stage 4, right eye
H35.152 Retinopathy of prematurity, stage 4, left eye
H35.153 Retinopathy of prematurity, stage 4, bilateral
H35.161 Retinopathy of prematurity, stage 5, right eye
H35.162 Retinopathy of prematurity, stage 5, left eye
H35.163 Retinopathy of prematurity, stage 5, bilateral
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 - H35.3114 Nonexudative age-related macular degeneration, right eye, stage unspecified - Nonexudative age-related macular degeneration, right eye, advanced atrophic with subfoveal involvement
H35.3120 - H35.3124 Nonexudative age-related macular degeneration, left eye, stage unspecified - Nonexudative age-related macular degeneration, left eye, advanced atrophic with subfoveal involvement
H35.3130 - H35.3134 Nonexudative age-related macular degeneration, bilateral, stage unspecified - Nonexudative age-related macular degeneration, bilateral, advanced atrophic with subfoveal involvement
H35.3210 - H35.3213 Exudative age-related macular degeneration, right eye, stage unspecified - Exudative age-related macular degeneration, right eye, with inactive scar
H35.3220 - H35.3223 Exudative age-related macular degeneration, left eye, stage unspecified - Exudative age-related macular degeneration, left eye, with inactive scar
H35.3230 - H35.3233 Exudative age-related macular degeneration, bilateral, stage unspecified - 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
H36.811 - H36.813 Nonproliferative sickle-cell retinopathy, right eye - Nonproliferative sickle-cell retinopathy, bilateral
H36.821 - H36.823 Proliferative sickle-cell retinopathy, right eye - Proliferative sickle-cell retinopathy, bilateral
H36.89 Other retinal disorders in diseases classified elsewhere
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 - H40.1114 Primary open-angle glaucoma, right eye, stage unspecified - Primary open-angle glaucoma, right eye, indeterminate stage
H40.1120 - H40.1124 Primary open-angle glaucoma, left eye, stage unspecified - Primary open-angle glaucoma, left eye, indeterminate stage
H40.1130 - H40.1134 Primary open-angle glaucoma, bilateral, stage unspecified - Primary open-angle glaucoma, bilateral, indeterminate stage
H40.1190 - H40.1194 Primary open-angle glaucoma, unspecified eye, stage unspecified - Primary open-angle glaucoma, unspecified eye, 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
H43.01 Vitreous prolapse, right eye
H43.02 Vitreous prolapse, left eye
H43.03 Vitreous prolapse, bilateral
H43.11 Vitreous hemorrhage, right eye
H43.12 Vitreous hemorrhage, left eye
H43.13 Vitreous hemorrhage, bilateral
H43.21 Crystalline deposits in vitreous body, right eye
H43.22 Crystalline deposits in vitreous body, left eye
H43.23 Crystalline deposits in vitreous body, bilateral
H43.311 Vitreous membranes and strands, right eye
H43.312 Vitreous membranes and strands, left eye
H43.313 Vitreous membranes and strands, bilateral
H43.391 Other vitreous opacities, right eye
H43.392 Other vitreous opacities, left eye
H43.393 Other vitreous opacities, bilateral
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
H43.89 Other disorders of vitreous body
H44.001 Unspecified purulent endophthalmitis, right eye
H44.002 Unspecified purulent endophthalmitis, left eye
H44.003 Unspecified purulent endophthalmitis, bilateral
H44.011 Panophthalmitis (acute), right eye
H44.012 Panophthalmitis (acute), left eye
H44.013 Panophthalmitis (acute), bilateral
H44.021 Vitreous abscess (chronic), right eye
H44.022 Vitreous abscess (chronic), left eye
H44.023 Vitreous abscess (chronic), bilateral
H44.111 Panuveitis, right eye
H44.112 Panuveitis, left eye
H44.113 Panuveitis, bilateral
H44.121 Parasitic endophthalmitis, unspecified, right eye
H44.122 Parasitic endophthalmitis, unspecified, left eye
H44.123 Parasitic endophthalmitis, unspecified, bilateral
H44.131 Sympathetic uveitis, right eye
H44.132 Sympathetic uveitis, left eye
H44.133 Sympathetic uveitis, bilateral
H44.19 Other endophthalmitis
H44.21 Degenerative myopia, right eye
H44.22 Degenerative myopia, left eye
H44.23 Degenerative myopia, 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
H44.2A9 Degenerative myopia with choroidal neovascularization, unspecified eye
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
H44.2B9 Degenerative myopia with macular hole, unspecified eye
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
H44.2C9 Degenerative myopia with retinal detachment, unspecified eye
H44.2D1 Degenerative myopia with foveoschisis, right eye
H44.2D2 Degenerative myopia with foveoschisis, left eye
H44.2D3 Degenerative myopia with foveoschisis, bilateral
H44.2D9 Degenerative myopia with foveoschisis, unspecified eye
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
H44.2E9 Degenerative myopia with other maculopathy, unspecified eye
H44.311 Chalcosis, right eye
H44.312 Chalcosis, left eye
H44.313 Chalcosis, bilateral
H44.321 Siderosis of eye, right eye
H44.322 Siderosis of eye, left eye
H44.323 Siderosis of eye, bilateral
H44.391 Other degenerative disorders of globe, right eye
H44.392 Other degenerative disorders of globe, left eye
H44.393 Other degenerative disorders of globe, bilateral
H44.411 Flat anterior chamber hypotony of right eye
H44.412 Flat anterior chamber hypotony of left eye
H44.413 Flat anterior chamber hypotony of eye, bilateral
H44.421 Hypotony of right eye due to ocular fistula
H44.422 Hypotony of left eye due to ocular fistula
H44.423 Hypotony of eye due to ocular fistula, bilateral
H44.431 Hypotony of eye due to other ocular disorders, right eye
H44.432 Hypotony of eye due to other ocular disorders, left eye
H44.433 Hypotony of eye due to other ocular disorders, bilateral
H44.441 Primary hypotony of right eye
H44.442 Primary hypotony of left eye
H44.443 Primary hypotony of eye, bilateral
H44.511 Absolute glaucoma, right eye
H44.512 Absolute glaucoma, left eye
H44.513 Absolute glaucoma, bilateral
H44.521 Atrophy of globe, right eye
H44.522 Atrophy of globe, left eye
H44.523 Atrophy of globe, bilateral
H44.531 Leucocoria, right eye
H44.532 Leucocoria, left eye
H44.533 Leucocoria, bilateral
H44.601 Unspecified retained (old) intraocular foreign body, magnetic, right eye
H44.602 Unspecified retained (old) intraocular foreign body, magnetic, left eye
H44.603 Unspecified retained (old) intraocular foreign body, magnetic, bilateral
H44.611 Retained (old) magnetic foreign body in anterior chamber, right eye
H44.612 Retained (old) magnetic foreign body in anterior chamber, left eye
H44.613 Retained (old) magnetic foreign body in anterior chamber, bilateral
H44.621 Retained (old) magnetic foreign body in iris or ciliary body, right eye
H44.622 Retained (old) magnetic foreign body in iris or ciliary body, left eye
H44.623 Retained (old) magnetic foreign body in iris or ciliary body, bilateral
H44.631 Retained (old) magnetic foreign body in lens, right eye
H44.632 Retained (old) magnetic foreign body in lens, left eye
H44.633 Retained (old) magnetic foreign body in lens, bilateral
H44.641 Retained (old) magnetic foreign body in posterior wall of globe, right eye
H44.642 Retained (old) magnetic foreign body in posterior wall of globe, left eye
H44.643 Retained (old) magnetic foreign body in posterior wall of globe, bilateral
H44.651 Retained (old) magnetic foreign body in vitreous body, right eye
H44.652 Retained (old) magnetic foreign body in vitreous body, left eye
H44.653 Retained (old) magnetic foreign body in vitreous body, bilateral
H44.691 Retained (old) intraocular foreign body, magnetic, in other or multiple sites, right eye
H44.692 Retained (old) intraocular foreign body, magnetic, in other or multiple sites, left eye
H44.693 Retained (old) intraocular foreign body, magnetic, in other or multiple sites, bilateral
H44.701 Unspecified retained (old) intraocular foreign body, nonmagnetic, right eye
H44.702 Unspecified retained (old) intraocular foreign body, nonmagnetic, left eye
H44.703 Unspecified retained (old) intraocular foreign body, nonmagnetic, bilateral
H44.711 Retained (nonmagnetic) (old) foreign body in anterior chamber, right eye
H44.712 Retained (nonmagnetic) (old) foreign body in anterior chamber, left eye
H44.713 Retained (nonmagnetic) (old) foreign body in anterior chamber, bilateral
H44.721 Retained (nonmagnetic) (old) foreign body in iris or ciliary body, right eye
H44.722 Retained (nonmagnetic) (old) foreign body in iris or ciliary body, left eye
H44.723 Retained (nonmagnetic) (old) foreign body in iris or ciliary body, bilateral
H44.731 Retained (nonmagnetic) (old) foreign body in lens, right eye
H44.732 Retained (nonmagnetic) (old) foreign body in lens, left eye
H44.733 Retained (nonmagnetic) (old) foreign body in lens, bilateral
H44.741 Retained (nonmagnetic) (old) foreign body in posterior wall of globe, right eye
H44.742 Retained (nonmagnetic) (old) foreign body in posterior wall of globe, left eye
H44.743 Retained (nonmagnetic) (old) foreign body in posterior wall of globe, bilateral
H44.751 Retained (nonmagnetic) (old) foreign body in vitreous body, right eye
H44.752 Retained (nonmagnetic) (old) foreign body in vitreous body, left eye
H44.753 Retained (nonmagnetic) (old) foreign body in vitreous body, bilateral
H44.791 Retained (old) intraocular foreign body, nonmagnetic, in other or multiple sites, right eye
H44.792 Retained (old) intraocular foreign body, nonmagnetic, in other or multiple sites, left eye
H44.793 Retained (old) intraocular foreign body, nonmagnetic, in other or multiple sites, bilateral
H44.811 Hemophthalmos, right eye
H44.812 Hemophthalmos, left eye
H44.813 Hemophthalmos, bilateral
H44.821 Luxation of globe, right eye
H44.822 Luxation of globe, left eye
H44.823 Luxation of globe, bilateral
H44.89 Other disorders of globe
H44.9 Unspecified disorder of globe
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
H46.2 Nutritional optic neuropathy
H46.3 Toxic optic neuropathy
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
H47.021 Hemorrhage in optic nerve sheath, right eye
H47.022 Hemorrhage in optic nerve sheath, left eye
H47.023 Hemorrhage in optic nerve sheath, bilateral
H47.091 Other disorders of optic nerve, not elsewhere classified, right eye
H47.092 Other disorders of optic nerve, not elsewhere classified, left eye
H47.093 Other disorders of optic nerve, not elsewhere classified, 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
H47.22 Hereditary optic atrophy
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
H47.311 Coloboma of optic disc, right eye
H47.312 Coloboma of optic disc, left eye
H47.313 Coloboma of optic disc, 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
H47.41 Disorders of optic chiasm in (due to) inflammatory disorders
H47.42 Disorders of optic chiasm in (due to) neoplasm
H47.43 Disorders of optic chiasm in (due to) vascular disorders
H47.49 Disorders of optic chiasm in (due to) other disorders
H53.121 Transient visual loss, right eye
H53.122 Transient visual loss, left eye
H53.123 Transient visual loss, bilateral
H53.131 Sudden visual loss, right eye
H53.132 Sudden visual loss, left eye
H53.133 Sudden visual loss, bilateral
H53.141 Visual discomfort, right eye
H53.142 Visual discomfort, left eye
H53.143 Visual discomfort, bilateral
H53.15 Visual distortions of shape and size
H53.16 Psychophysical visual disturbances
H53.19 Other subjective visual disturbances
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
H53.71 Glare sensitivity
H53.72 Impaired contrast sensitivity
H53.8 Other visual disturbances
H53.9 Unspecified visual disturbance
H54.0X33 Blindness right eye category 3, blindness left eye category 3
H54.0X34 Blindness right eye category 3, blindness left eye category 4
H54.0X35 Blindness right eye category 3, blindness left eye category 5
H54.0X43 Blindness right eye category 4, blindness left eye category 3
H54.0X44 Blindness right eye category 4, blindness left eye category 4
H54.0X45 Blindness right eye category 4, blindness left eye category 5
H54.0X53 Blindness right eye category 5, blindness left eye category 3
H54.0X54 Blindness right eye category 5, blindness left eye category 4
H54.0X55 Blindness right eye category 5, blindness left eye category 5
H54.1131 Blindness right eye category 3, low vision left eye category 1
H54.1132 Blindness right eye category 3, low vision left eye category 2
H54.1141 Blindness right eye category 4, low vision left eye category 1
H54.1142 Blindness right eye category 4, low vision left eye category 2
H54.1151 Blindness right eye category 5, low vision left eye category 1
H54.1152 Blindness right eye category 5, low vision left eye category 2
H54.1213 Low vision right eye category 1, blindness left eye category 3
H54.1214 Low vision right eye category 1, blindness left eye category 4
H54.1215 Low vision right eye category 1, blindness left eye category 5
H54.1223 Low vision right eye category 2, blindness left eye category 3
H54.1224 Low vision right eye category 2, blindness left eye category 4
H54.1225 Low vision right eye category 2, blindness left eye category 5
H54.2X11 Low vision right eye category 1, low vision left eye category 1
H54.2X12 Low vision right eye category 1, low vision left eye category 2
H54.2X21 Low vision right eye category 2, low vision left eye category 1
H54.2X22 Low vision right eye category 2, low vision left eye category 2
H54.413A Blindness right eye category 3, normal vision left eye
H54.414A Blindness right eye category 4, normal vision left eye
H54.415A Blindness right eye category 5, normal vision left eye
H54.42A3 Blindness left eye category 3, normal vision right eye
H54.42A4 Blindness left eye category 4, normal vision right eye
H54.42A5 Blindness left eye category 5, normal vision right eye
H54.511A Low vision right eye category 1, normal vision left eye
H54.512A Low vision right eye category 2, normal vision left eye
H54.52A1 Low vision left eye category 1, normal vision right eye
H54.52A2 Low vision left eye category 2, normal vision right eye
M05.9 Rheumatoid arthritis with rheumatoid factor, unspecified
M06.9 Rheumatoid arthritis, unspecified
M08.89 Other juvenile arthritis, multiple sites
Q14.0 Congenital malformation of vitreous humor
Q14.1 Congenital malformation of retina
Q14.2 Congenital malformation of optic disc
Q14.3 Congenital malformation of choroid
Q14.8 Other congenital malformations of posterior segment of eye
Q14.9 Congenital malformation of posterior segment of eye, unspecified
Q15.0 Congenital glaucoma
Q15.8 Other specified congenital malformations of eye
Q15.9 Congenital malformation of eye, unspecified
Q85.1 Tuberous sclerosis
Q85.81 PTEN hamartoma tumor syndrome
Q85.82 Other Cowden syndrome
Q85.83 Von Hippel-Lindau syndrome
Q85.89 Other phakomatoses, not elsewhere classified
Q87.410 Marfan syndrome with aortic dilation
Q87.418 Marfan syndrome with other cardiovascular manifestations
Q87.42 Marfan syndrome with ocular manifestations
Q87.43 Marfan syndrome with skeletal manifestation
R44.1 Visual hallucinations
R48.3 Visual agnosia
S05.20XA Ocular laceration and rupture with prolapse or loss of intraocular tissue, unspecified eye, initial encounter
S05.20XD Ocular laceration and rupture with prolapse or loss of intraocular tissue, unspecified eye, subsequent encounter
S05.20XS Ocular laceration and rupture with prolapse or loss of intraocular tissue, unspecified eye, sequela
S05.21XA Ocular laceration and rupture with prolapse or loss of intraocular tissue, right eye, initial encounter
S05.21XD Ocular laceration and rupture with prolapse or loss of intraocular tissue, right eye, subsequent encounter
S05.21XS Ocular laceration and rupture with prolapse or loss of intraocular tissue, right eye, sequela
S05.22XA Ocular laceration and rupture with prolapse or loss of intraocular tissue, left eye, initial encounter
S05.22XD Ocular laceration and rupture with prolapse or loss of intraocular tissue, left eye, subsequent encounter
S05.22XS Ocular laceration and rupture with prolapse or loss of intraocular tissue, left eye, sequela
S05.31XA Ocular laceration without prolapse or loss of intraocular tissue, right eye, initial encounter
S05.31XD Ocular laceration without prolapse or loss of intraocular tissue, right eye, subsequent encounter
S05.31XS Ocular laceration without prolapse or loss of intraocular tissue, right eye, sequela
S05.32XA Ocular laceration without prolapse or loss of intraocular tissue, left eye, initial encounter
S05.32XD Ocular laceration without prolapse or loss of intraocular tissue, left eye, subsequent encounter
S05.32XS Ocular laceration without prolapse or loss of intraocular tissue, left eye, sequela
S05.41XA Penetrating wound of orbit with or without foreign body, right eye, initial encounter
S05.41XD Penetrating wound of orbit with or without foreign body, right eye, subsequent encounter
S05.41XS Penetrating wound of orbit with or without foreign body, right eye, sequela
S05.42XA Penetrating wound of orbit with or without foreign body, left eye, initial encounter
S05.42XD Penetrating wound of orbit with or without foreign body, left eye, subsequent encounter
S05.42XS Penetrating wound of orbit with or without foreign body, left eye, sequela
S05.51XA Penetrating wound with foreign body of right eyeball, initial encounter
S05.51XD Penetrating wound with foreign body of right eyeball, subsequent encounter
S05.51XS Penetrating wound with foreign body of right eyeball, sequela
S05.52XA Penetrating wound with foreign body of left eyeball, initial encounter
S05.61XA Penetrating wound without foreign body of right eyeball, initial encounter
S05.61XD Penetrating wound without foreign body of right eyeball, subsequent encounter
S05.61XS Penetrating wound without foreign body of right eyeball, sequela
S05.62XA Penetrating wound without foreign body of left eyeball, initial encounter
S05.62XD Penetrating wound without foreign body of left eyeball, subsequent encounter
S05.62XS Penetrating wound without foreign body of left eyeball, sequela
Z09 Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm
Z79.899 Other long term (current) drug therapy

Group 2

(275 Codes)
Group 2 Paragraph

Additional ICD-10-CM codes for extended ophthalmoscopy (CPT codes 92201, 92202)

Group 2 Codes
Code Description
A18.54 Tuberculous iridocyclitis
C79.89 Secondary malignant neoplasm of other specified sites
E08.00 Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
E08.01 Diabetes mellitus due to underlying condition with hyperosmolarity with coma
E08.10 Diabetes mellitus due to underlying condition with ketoacidosis without coma
E08.11 Diabetes mellitus due to underlying condition with ketoacidosis with coma
E08.21 Diabetes mellitus due to underlying condition with diabetic nephropathy
E08.22 Diabetes mellitus due to underlying condition with diabetic chronic kidney disease
E08.29 Diabetes mellitus due to underlying condition with other diabetic kidney complication
E08.41 Diabetes mellitus due to underlying condition with diabetic mononeuropathy
E08.42 Diabetes mellitus due to underlying condition with diabetic polyneuropathy
E08.43 Diabetes mellitus due to underlying condition with diabetic autonomic (poly)neuropathy
E08.44 Diabetes mellitus due to underlying condition with diabetic amyotrophy
E08.49 Diabetes mellitus due to underlying condition with other diabetic neurological complication
E08.51 Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy without gangrene
E08.52 Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy with gangrene
E08.59 Diabetes mellitus due to underlying condition with other circulatory complications
E08.610 Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy
E08.618 Diabetes mellitus due to underlying condition with other diabetic arthropathy
E08.620 Diabetes mellitus due to underlying condition with diabetic dermatitis
E08.621 Diabetes mellitus due to underlying condition with foot ulcer
E08.622 Diabetes mellitus due to underlying condition with other skin ulcer
E08.628 Diabetes mellitus due to underlying condition with other skin complications
E08.630 Diabetes mellitus due to underlying condition with periodontal disease
E08.638 Diabetes mellitus due to underlying condition with other oral complications
E08.641 Diabetes mellitus due to underlying condition with hypoglycemia with coma
E08.649 Diabetes mellitus due to underlying condition with hypoglycemia without coma
E08.65 Diabetes mellitus due to underlying condition with hyperglycemia
E08.69 Diabetes mellitus due to underlying condition with other specified complication
E08.8 Diabetes mellitus due to underlying condition with unspecified complications
E08.9 Diabetes mellitus due to underlying condition without complications
E09.00 Drug or chemical induced diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
E09.01 Drug or chemical induced diabetes mellitus with hyperosmolarity with coma
E09.10 Drug or chemical induced diabetes mellitus with ketoacidosis without coma
E09.11 Drug or chemical induced diabetes mellitus with ketoacidosis with coma
E09.21 Drug or chemical induced diabetes mellitus with diabetic nephropathy
E09.22 Drug or chemical induced diabetes mellitus with diabetic chronic kidney disease
E09.29 Drug or chemical induced diabetes mellitus with other diabetic kidney complication
E09.41 Drug or chemical induced diabetes mellitus with neurological complications with diabetic mononeuropathy
E09.42 Drug or chemical induced diabetes mellitus with neurological complications with diabetic polyneuropathy
E09.43 Drug or chemical induced diabetes mellitus with neurological complications with diabetic autonomic (poly)neuropathy
E09.44 Drug or chemical induced diabetes mellitus with neurological complications with diabetic amyotrophy
E09.49 Drug or chemical induced diabetes mellitus with neurological complications with other diabetic neurological complication
E09.51 Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy without gangrene
E09.52 Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy with gangrene
E09.59 Drug or chemical induced diabetes mellitus with other circulatory complications
E09.610 Drug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy
E09.618 Drug or chemical induced diabetes mellitus with other diabetic arthropathy
E09.620 Drug or chemical induced diabetes mellitus with diabetic dermatitis
E09.621 Drug or chemical induced diabetes mellitus with foot ulcer
E09.622 Drug or chemical induced diabetes mellitus with other skin ulcer
E09.628 Drug or chemical induced diabetes mellitus with other skin complications
E09.630 Drug or chemical induced diabetes mellitus with periodontal disease
E09.638 Drug or chemical induced diabetes mellitus with other oral complications
E09.641 Drug or chemical induced diabetes mellitus with hypoglycemia with coma
E09.649 Drug or chemical induced diabetes mellitus with hypoglycemia without coma
E09.65 Drug or chemical induced diabetes mellitus with hyperglycemia
E09.69 Drug or chemical induced diabetes mellitus with other specified complication
E09.9 Drug or chemical induced diabetes mellitus without complications
E10.10 Type 1 diabetes mellitus with ketoacidosis without coma
E10.11 Type 1 diabetes mellitus with ketoacidosis with coma
E10.21 Type 1 diabetes mellitus with diabetic nephropathy
E10.22 Type 1 diabetes mellitus with diabetic chronic kidney disease
E10.29 Type 1 diabetes mellitus with other diabetic kidney complication
E10.641 Type 1 diabetes mellitus with hypoglycemia with coma
E10.65 Type 1 diabetes mellitus with hyperglycemia
E10.69 Type 1 diabetes mellitus with other specified complication
E10.9 Type 1 diabetes mellitus without complications
E11.00 Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
E11.01 Type 2 diabetes mellitus with hyperosmolarity with coma
E11.21 Type 2 diabetes mellitus with diabetic nephropathy
E11.22 Type 2 diabetes mellitus with diabetic chronic kidney disease
E11.29 Type 2 diabetes mellitus with other diabetic kidney complication
E11.641 Type 2 diabetes mellitus with hypoglycemia with coma
E11.649 Type 2 diabetes mellitus with hypoglycemia without coma
E11.65 Type 2 diabetes mellitus with hyperglycemia
E11.69 Type 2 diabetes mellitus with other specified complication
E11.9 Type 2 diabetes mellitus without complications
E13.00 Other specified diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
E13.01 Other specified diabetes mellitus with hyperosmolarity with coma
E13.10 Other specified diabetes mellitus with ketoacidosis without coma
E13.11 Other specified diabetes mellitus with ketoacidosis with coma
E13.21 Other specified diabetes mellitus with diabetic nephropathy
E13.22 Other specified diabetes mellitus with diabetic chronic kidney disease
E13.29 Other specified diabetes mellitus with other diabetic kidney complication
E13.40 Other specified diabetes mellitus with diabetic neuropathy, unspecified
E13.41 Other specified diabetes mellitus with diabetic mononeuropathy
E13.42 Other specified diabetes mellitus with diabetic polyneuropathy
E13.43 Other specified diabetes mellitus with diabetic autonomic (poly)neuropathy
E13.44 Other specified diabetes mellitus with diabetic amyotrophy
E13.49 Other specified diabetes mellitus with other diabetic neurological complication
E13.51 Other specified diabetes mellitus with diabetic peripheral angiopathy without gangrene
E13.52 Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene
E13.59 Other specified diabetes mellitus with other circulatory complications
E13.610 Other specified diabetes mellitus with diabetic neuropathic arthropathy
E13.618 Other specified diabetes mellitus with other diabetic arthropathy
E13.620 Other specified diabetes mellitus with diabetic dermatitis
E13.621 Other specified diabetes mellitus with foot ulcer
E13.622 Other specified diabetes mellitus with other skin ulcer
E13.628 Other specified diabetes mellitus with other skin complications
E13.630 Other specified diabetes mellitus with periodontal disease
E13.638 Other specified diabetes mellitus with other oral complications
E13.641 Other specified diabetes mellitus with hypoglycemia with coma
E13.649 Other specified diabetes mellitus with hypoglycemia without coma
E13.65 Other specified diabetes mellitus with hyperglycemia
E13.69 Other specified diabetes mellitus with other specified complication
E13.9 Other specified diabetes mellitus without complications
H05.30 Unspecified deformity of orbit
H05.311 Atrophy of right orbit
H05.312 Atrophy of left orbit
H05.313 Atrophy of bilateral orbit
H05.321 Deformity of right orbit due to bone disease
H05.322 Deformity of left orbit due to bone disease
H05.323 Deformity of bilateral orbits due to bone disease
H05.331 Deformity of right orbit due to trauma or surgery
H05.332 Deformity of left orbit due to trauma or surgery
H05.333 Deformity of bilateral orbits due to trauma or surgery
H05.341 Enlargement of right orbit
H05.342 Enlargement of left orbit
H05.343 Enlargement of bilateral orbits
H05.351 Exostosis of right orbit
H05.352 Exostosis of left orbit
H05.353 Exostosis of bilateral orbits
H05.411 Enophthalmos due to atrophy of orbital tissue, right eye
H05.412 Enophthalmos due to atrophy of orbital tissue, left eye
H05.413 Enophthalmos due to atrophy of orbital tissue, bilateral
H05.421 Enophthalmos due to trauma or surgery, right eye
H05.422 Enophthalmos due to trauma or surgery, left eye
H05.423 Enophthalmos due to trauma or surgery, bilateral
H05.51 Retained (old) foreign body following penetrating wound of right orbit
H05.52 Retained (old) foreign body following penetrating wound of left orbit
H05.53 Retained (old) foreign body following penetrating wound of bilateral orbits
H05.89 Other disorders of orbit
H20.00 Unspecified acute and subacute iridocyclitis
H20.011 Primary iridocyclitis, right eye
H20.012 Primary iridocyclitis, left eye
H20.013 Primary iridocyclitis, bilateral
H20.021 Recurrent acute iridocyclitis, right eye
H20.022 Recurrent acute iridocyclitis, left eye
H20.023 Recurrent acute iridocyclitis, bilateral
H20.031 Secondary infectious iridocyclitis, right eye
H20.032 Secondary infectious iridocyclitis, left eye
H20.033 Secondary infectious iridocyclitis, bilateral
H20.041 Secondary noninfectious iridocyclitis, right eye
H20.042 Secondary noninfectious iridocyclitis, left eye
H20.043 Secondary noninfectious iridocyclitis, bilateral
H20.11 Chronic iridocyclitis, right eye
H20.12 Chronic iridocyclitis, left eye
H20.13 Chronic iridocyclitis, bilateral
H20.21 Lens-induced iridocyclitis, right eye
H20.22 Lens-induced iridocyclitis, left eye
H20.23 Lens-induced iridocyclitis, bilateral
H20.811 Fuchs' heterochromic cyclitis, right eye
H20.812 Fuchs' heterochromic cyclitis, left eye
H20.813 Fuchs' heterochromic cyclitis, bilateral
H21.01 Hyphema, right eye
H21.02 Hyphema, left eye
H21.03 Hyphema, bilateral
H21.1X1 Other vascular disorders of iris and ciliary body, right eye
H21.1X2 Other vascular disorders of iris and ciliary body, left eye
H21.1X3 Other vascular disorders of iris and ciliary body, bilateral
H21.211 Degeneration of chamber angle, right eye
H21.212 Degeneration of chamber angle, left eye
H21.213 Degeneration of chamber angle, 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
H21.241 Degeneration of pupillary margin, right eye
H21.242 Degeneration of pupillary margin, left eye
H21.243 Degeneration of pupillary margin, bilateral
H21.251 Iridoschisis, right eye
H21.252 Iridoschisis, left eye
H21.253 Iridoschisis, bilateral
H21.261 Iris atrophy (essential) (progressive), right eye
H21.262 Iris atrophy (essential) (progressive), left eye
H21.263 Iris atrophy (essential) (progressive), bilateral
H21.271 Miotic pupillary cyst, right eye
H21.272 Miotic pupillary cyst, left eye
H21.273 Miotic pupillary cyst, bilateral
H21.29 Other iris atrophy
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
H21.341 Primary cyst of pars plana, right eye
H21.342 Primary cyst of pars plana, left eye
H21.343 Primary cyst of pars plana, bilateral
H21.351 Exudative cyst of pars plana, right eye
H21.352 Exudative cyst of pars plana, left eye
H21.353 Exudative cyst of pars plana, bilateral
H21.41 Pupillary membranes, right eye
H21.42 Pupillary membranes, left eye
H21.43 Pupillary membranes, bilateral
H21.511 Anterior synechiae (iris), right eye
H21.512 Anterior synechiae (iris), left eye
H21.513 Anterior synechiae (iris), bilateral
H21.521 Goniosynechiae, right eye
H21.522 Goniosynechiae, left eye
H21.523 Goniosynechiae, bilateral
H21.531 Iridodialysis, right eye
H21.532 Iridodialysis, left eye
H21.533 Iridodialysis, bilateral
H21.541 Posterior synechiae (iris), right eye
H21.542 Posterior synechiae (iris), left eye
H21.543 Posterior synechiae (iris), bilateral
H21.551 Recession of chamber angle, right eye
H21.552 Recession of chamber angle, left eye
H21.553 Recession of chamber angle, bilateral
H21.561 Pupillary abnormality, right eye
H21.562 Pupillary abnormality, left eye
H21.563 Pupillary abnormality, bilateral
H21.81 Floppy iris syndrome
H21.89 Other specified disorders of iris and ciliary body
H22 Disorders of iris and ciliary body in diseases classified elsewhere
H53.461 Homonymous bilateral field defects, right side
H53.462 Homonymous bilateral field defects, left side
H53.47 Heteronymous bilateral field defects
H53.50 Unspecified color vision deficiencies
H53.61 Abnormal dark adaptation curve
H53.62 Acquired night blindness
H53.63 Congenital night blindness
H53.69 Other night blindness
S05.11XA Contusion of eyeball and orbital tissues, right eye, initial encounter
S05.11XD Contusion of eyeball and orbital tissues, right eye, subsequent encounter
S05.11XS Contusion of eyeball and orbital tissues, right eye, sequela
S05.12XA Contusion of eyeball and orbital tissues, left eye, initial encounter
S05.12XD Contusion of eyeball and orbital tissues, left eye, subsequent encounter
S05.12XS Contusion of eyeball and orbital tissues, left eye, sequela
S05.8X1A Other injuries of right eye and orbit, initial encounter
S05.8X1D Other injuries of right eye and orbit, subsequent encounter
S05.8X1S Other injuries of right eye and orbit, sequela
S05.8X2A Other injuries of left eye and orbit, initial encounter
S05.8X2D Other injuries of left eye and orbit, subsequent encounter
S05.8X2S Other injuries of left eye and orbit, sequela
T74.02XA Child neglect or abandonment, confirmed, initial encounter
T74.02XD Child neglect or abandonment, confirmed, subsequent encounter
T74.02XS Child neglect or abandonment, confirmed, sequela
T74.12XA Child physical abuse, confirmed, initial encounter
T74.12XD Child physical abuse, confirmed, subsequent encounter
T74.12XS Child physical abuse, confirmed, sequela
T74.22XA Child sexual abuse, confirmed, initial encounter
T74.22XD Child sexual abuse, confirmed, subsequent encounter
T74.22XS Child sexual abuse, confirmed, sequela
T74.32XA Child psychological abuse, confirmed, initial encounter
T74.32XD Child psychological abuse, confirmed, subsequent encounter
T74.32XS Child psychological abuse, confirmed, sequela
T74.4XXA Shaken infant syndrome, initial encounter
T74.4XXD Shaken infant syndrome, subsequent encounter
T74.4XXS Shaken infant syndrome, sequela
T74.92XA Unspecified child maltreatment, confirmed, initial encounter
T74.92XD Unspecified child maltreatment, confirmed, subsequent encounter
T74.92XS Unspecified child maltreatment, confirmed, sequela
T76.02XA Child neglect or abandonment, suspected, initial encounter
T76.02XD Child neglect or abandonment, suspected, subsequent encounter
T76.02XS Child neglect or abandonment, suspected, sequela
T76.12XA Child physical abuse, suspected, initial encounter
T76.12XD Child physical abuse, suspected, subsequent encounter
T76.12XS Child physical abuse, suspected, sequela
T76.22XA Child sexual abuse, suspected, initial encounter
T76.22XD Child sexual abuse, suspected, subsequent encounter
T76.22XS Child sexual abuse, suspected, sequela
T76.32XA Child psychological abuse, suspected, initial encounter
T76.32XD Child psychological abuse, suspected, subsequent encounter
T76.32XS Child psychological abuse, suspected, sequela
T79.1XXA Fat embolism (traumatic), initial encounter
T79.1XXD Fat embolism (traumatic), subsequent encounter
T79.1XXS Fat embolism (traumatic), sequela

Group 3

(132 Codes)
Group 3 Paragraph

Additional ICD-10-CM codes for fundus photography (CPT codes 92228, 92250)

Group 3 Codes
Code Description
A18.51 Tuberculous episcleritis
A52.15 Late syphilitic neuropathy
B20 Human immunodeficiency virus [HIV] disease
B58.09 Other toxoplasma oculopathy
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
C69.51 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
C69.91 Malignant neoplasm of unspecified site of right eye
C69.92 Malignant neoplasm of unspecified site of left eye
C79.32 Secondary malignant neoplasm of cerebral meninges
C79.49 Secondary malignant neoplasm of other parts of nervous system
D09.21 Carcinoma in situ of right eye
D09.22 Carcinoma in situ of left eye
D31.41 Benign neoplasm of right ciliary body
D31.42 Benign neoplasm of left ciliary body
D48.7 Neoplasm of uncertain behavior of other specified sites
D49.81 Neoplasm of unspecified behavior of retina and choroid
D49.89 Neoplasm of unspecified behavior of other specified sites
D57.01 Hb-SS disease with acute chest syndrome
D57.02 Hb-SS disease with splenic sequestration
D57.03 Hb-SS disease with cerebral vascular involvement
D57.04 Hb-SS disease with dactylitis
D57.09 Hb-SS disease with crisis with other specified complication
D57.1 Sickle-cell disease without crisis
D57.20 Sickle-cell/Hb-C disease without crisis
D57.211 Sickle-cell/Hb-C disease with acute chest syndrome
D57.212 Sickle-cell/Hb-C disease with splenic sequestration
D57.213 Sickle-cell/Hb-C disease with cerebral vascular involvement
D57.218 Sickle-cell/Hb-C disease with crisis with other specified complication
D57.80 Other sickle-cell disorders without crisis
D57.811 Other sickle-cell disorders with acute chest syndrome
D57.812 Other sickle-cell disorders with splenic sequestration
D57.813 Other sickle-cell disorders with cerebral vascular involvement
D57.818 Other sickle-cell disorders with crisis with other specified complication
D57.819 Other sickle-cell disorders with crisis, unspecified
E70.21 Tyrosinemia
E70.29 Other disorders of tyrosine metabolism
E70.310 X-linked ocular albinism
E70.311 Autosomal recessive ocular albinism
E70.318 Other ocular albinism
E70.320 Tyrosinase negative oculocutaneous albinism
E70.321 Tyrosinase positive oculocutaneous albinism
E70.328 Other oculocutaneous albinism
E70.330 Chediak-Higashi syndrome
E70.331 Hermansky-Pudlak syndrome
E70.338 Other albinism with hematologic abnormality
E70.39 Other specified albinism
E70.5 Disorders of tryptophan metabolism
E78.71 Barth syndrome
E78.72 Smith-Lemli-Opitz syndrome
G35 Multiple sclerosis
H15.091 Other scleritis, right eye
H15.092 Other scleritis, left eye
H15.093 Other scleritis, bilateral
H15.841 Scleral ectasia, right eye
H15.842 Scleral ectasia, left eye
H15.843 Scleral ectasia, bilateral
H47.031 Optic nerve hypoplasia, right eye
H47.032 Optic nerve hypoplasia, left eye
H47.033 Optic nerve hypoplasia, bilateral
H47.511 Disorders of visual pathways in (due to) inflammatory disorders, right side
H47.512 Disorders of visual pathways in (due to) inflammatory disorders, left side
H47.521 Disorders of visual pathways in (due to) neoplasm, right side
H47.522 Disorders of visual pathways in (due to) neoplasm, left side
H47.531 Disorders of visual pathways in (due to) vascular disorders, right side
H47.532 Disorders of visual pathways in (due to) vascular disorders, left side
H47.611 Cortical blindness, right side of brain
H47.612 Cortical blindness, left side of brain
H47.621 Disorders of visual cortex in (due to) inflammatory disorders, right side of brain
H47.622 Disorders of visual cortex in (due to) inflammatory disorders, left side of brain
H47.631 Disorders of visual cortex in (due to) neoplasm, right side of brain
H47.632 Disorders of visual cortex in (due to) neoplasm, left side of brain
H47.641 Disorders of visual cortex in (due to) vascular disorders, right side of brain
H47.642 Disorders of visual cortex in (due to) vascular disorders, left side of brain
H47.9 Unspecified disorder of visual pathways
H53.51 Achromatopsia
H53.52 Acquired color vision deficiency
H53.53 Deuteranomaly
H53.54 Protanomaly
H53.55 Tritanomaly
H53.59 Other color vision deficiencies
H55.81 Deficient saccadic eye movements
H55.82 Deficient smooth pursuit eye movements
L93.0 Discoid lupus erythematosus
L93.1 Subacute cutaneous lupus erythematosus
L93.2 Other local lupus erythematosus
M05.00 Felty's syndrome, unspecified site
M05.10 Rheumatoid lung disease with rheumatoid arthritis of unspecified site
M05.20 Rheumatoid vasculitis with rheumatoid arthritis of unspecified site
M05.30 Rheumatoid heart disease with rheumatoid arthritis of unspecified site
M05.60 Rheumatoid arthritis of unspecified site with involvement of other organs and systems
M06.1 Adult-onset Still's disease
M06.4 Inflammatory polyarthropathy
M12.00 Chronic postrheumatic arthropathy [Jaccoud], unspecified site
M32.0 Drug-induced systemic lupus erythematosus
M32.10 Systemic lupus erythematosus, organ or system involvement unspecified
M32.19 Other organ or system involvement in systemic lupus erythematosus
M32.9 Systemic lupus erythematosus, unspecified
P35.0 Congenital rubella syndrome
Q87.11 Prader-Willi syndrome
Q87.19 Other congenital malformation syndromes predominantly associated with short stature
Q87.2 Congenital malformation syndromes predominantly involving limbs
Q87.3 Congenital malformation syndromes involving early overgrowth
Q87.5 Other congenital malformation syndromes with other skeletal changes
Q87.81 Alport syndrome
Q87.89 Other specified congenital malformation syndromes, not elsewhere classified
Q89.8 Other specified congenital malformations
Q99.2 Fragile X chromosome
R94.110 Abnormal electro-oculogram [EOG]
R94.111 Abnormal electroretinogram [ERG]
R94.112 Abnormal visually evoked potential [VEP]
R94.113 Abnormal oculomotor study
T37.2X1A Poisoning by antimalarials and drugs acting on other blood protozoa, accidental (unintentional), initial encounter
T37.2X2A Poisoning by antimalarials and drugs acting on other blood protozoa, intentional self-harm, initial encounter
T37.2X3A Poisoning by antimalarials and drugs acting on other blood protozoa, assault, initial encounter
T37.2X4A Poisoning by antimalarials and drugs acting on other blood protozoa, undetermined, initial encounter
T74.12XA Child physical abuse, confirmed, initial encounter
T74.12XD Child physical abuse, confirmed, subsequent encounter
T74.12XS Child physical abuse, confirmed, sequela
T74.4XXA Shaken infant syndrome, initial encounter
T74.4XXD Shaken infant syndrome, subsequent encounter
T74.4XXS Shaken infant syndrome, sequela
T76.12XA Child physical abuse, suspected, initial encounter
T76.12XD Child physical abuse, suspected, subsequent encounter
T76.12XS Child physical abuse, suspected, sequela
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ICD-10-CM Codes that DO NOT Support Medical Necessity

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Group 1 Codes

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ICD-10-PCS Codes

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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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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 R8

Due to the annual ICD-10-CM update, effective for services rendered on or after 10/01/2024, the descriptions of the following codes in the ICD-10-CM Codes That Support Medical Necessity section- Group 1 have been changed: H44.2A3, H44.2B3, H44.2C3, H44.2D3. H44.2E3.

01/01/2024 R7

Either the short and/or long code description was changed for the code 92250. Please Note: Depending on which descriptor was used, there may not be any changes to the code display in this document:

10/01/2023 R6

Due to the annual ICD-10 updates for 2024, the following coding has been revised:

  • ICD-10 code H36 has been deleted and codes H36.811, H36.812, H36.813, H36.821, H36.822, H36.823, and H36.89 have been added to group 1.
  • ICD-10 code D57.04 was added to group 3.
  • Q85.81 descriptor was changed in Group 1
    Q87.410 descriptor was changed in Group 1
    Q87.418 descriptor was changed in Group 1
    Q87.42 descriptor was changed in Group 1
    Q87.43 descriptor was changed in Group 1
10/01/2022 R5

Due to the annual ICD-10 updates for 2023, ICD-10 code Q85.8 was deleted and replaced by Q85.81, Q85.82, Q85.83 and Q85.89.

01/01/2021 R4

Due to the 2021 annual HCPCS update, the descriptors for CPT codes 92227 and 92228 have been revised.

10/01/2020 R3

Due to the annual ICD-10-CM update, ICD-10-CM codes H55.81, H55.82, D57.03. D57.09, D57.213, D57.218, D57.813, and D57.818 were added to Group 3- "ICD-10-CM Codes That Support Medical Necessity" section.  

ICD-10-CM code E70.8 was deleted from Group 3.

01/01/2020 R2

Due to the annual CPT/HCPCS update, effective for services rendered on or after January 1, 2020, CPT codes 92225 and 92226 were deleted. CPT codes 92201 and 92202 were added to CPT/HCPCS section- Groups 1 and 2.

10/01/2019 R1

This article was converted to the new Billing and Coding Article type.

Bill types and Revenue codes have been removed from this article. Guidance on these codes is available in the Bill type and Revenue code sections.

Due to the annual ICD-10-CM update, ICD-10-CM diagnosis code Q87.1 was deleted from "ICD-10 Codes that Support Medical Necessity" section- (Group 3), and ICD-10-CM diagnosis codes Q87.11 and Q87.19 were added to "ICD-10 Codes that Support Medical Necessity" section- (Group 3), effective for services rendered on or after 10/1/2019.

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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 2
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