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Compare/H33.1 vs H35.42

H33.1 vs H35.42

H33.1 (Retinoschisis and retinal cysts) compared with H35.42 (Microcystoid degeneration of retina), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

No — do not report together. H33.1 carries an Excludes1 note covering H35.42: “microcystoid degeneration of retina (H35.42-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

H33.1Retinoschisis and retinal cystsH35.42Microcystoid degeneration of retina
Billing statusNon-billable header

Report instead: H33.101, H33.102, H33.103, H33.109, H33.111

Non-billable header

Report instead: H35.421, H35.422, H35.423, H35.429

ClassificationH00-H59 — Diseases of the Eye and Adnexa (H00-H59)H00-H59 — Diseases of the Eye and Adnexa (H00-H59)
DefinitionRetinoschisis and retinal cysts is a non-billable ICD-10-CM category code (H33.1).Microcystoid degeneration of retina is a non-billable ICD-10-CM category code (H35.42).

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