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H31.011 vs H31.012

H31.011 (Macula scars of posterior pole (postinflammatory) (post-traumatic), right eye) compared with H31.012 (Macula scars of posterior pole (postinflammatory) (post-traumatic), left eye), from the official CMS tabular data. H31.011 and H31.012 code the same condition on opposite sides.

Relationship

Review

Laterality relationship

H31.011
Right
Macula scars of posterior pole (postinflammatory) (post-traumatic), right eye
H31.012
Left
Macula scars of posterior pole (postinflammatory) (post-traumatic), left eye

Same condition; these differ only in which side is documented.

These codes share a category and title and differ only in the side affected. The documentation decides which applies, and a bilateral code is reported only where the code set provides one.

Source: ICD-10-CM tabular list (laterality variant derived from the code title)

Can these codes be reported together?

Same condition, opposite side. H31.011 and H31.012 name the same condition on opposite sides of the body.

Same category and title, differing only in which side is affected — the documentation decides which one applies, and a bilateral code is reported only where the code set provides one.

Side by side

H31.011Macula scars of posterior pole (postinflammatory) (post-traumatic), right eyeH31.012Macula scars of posterior pole (postinflammatory) (post-traumatic), left eye
Billing statusBillableBillable
ClassificationH00-H59 — Diseases of the Eye and Adnexa (H00-H59)H00-H59 — Diseases of the Eye and Adnexa (H00-H59)
DefinitionMacula scars of posterior pole (postinflammatory) (post-traumatic), right eye is a billable ICD-10-CM diagnosis code (H31.011).Macula scars of posterior pole (postinflammatory) (post-traumatic), left eye is a billable ICD-10-CM diagnosis code (H31.012).

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources