H31.329 ICD-10-CM Code: Choroidal rupture, unspecified eye
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Inpatient Payment Groups (MS-DRG)
Potential MS-DRG participation — not a DRG assignment.
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.
- MS-DRG 124 — OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT (MDC 02)
- MS-DRG 125 — OTHER DISORDERS OF THE EYE WITHOUT MCC (MDC 02)
A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.
Coder workflow for H31.329
MedCoder structured workflow — derived from this code’s own official record
Before you code H31.329
- Unspecified does not mean incorrect. When the record gives no greater specificity, H31.329 may be the appropriate code. Check the record for detail that supports a more specific sibling. An unspecified code is for records that do not provide the detail a more specific code needs; a query, not an assumption, is the route to specificity (Guidelines I.A.9.b, I.B.18).
ReviewH31.321, H31.322, H31.323
See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →
- Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: unspecified). The unspecified-side code applies only when the record states no side. Laterality is assigned from the documented side; where a bilateral code exists and both sides are documented, it is used instead of two unilateral codes (Guidelines I.B.13).
ReviewH31.321 · right, H31.322 · left
Choose the right path
- Does the record document the detail a more specific sibling code needs?
Yes → Review the specific siblings in this subcategory.
No → Continue — H31.329 is appropriate when the documentation goes no further. - Is the side documented?
Yes → Select the code for the documented side (or the bilateral code when both sides are documented and one exists).
No → Use the unspecified-side code only when the record states no side; a query is the alternative.ReviewH31.321 · right, H31.322 · left
Consider H31.329. Then confirm the code is valid for the date of service in the Verify section.
Documentation check
- The provider’s diagnostic statement
- Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
- Laterality
- Right, left or bilateral as documented; unspecified only when the record states no side (Guidelines I.B.13).
- Any detail beyond this code’s title
- What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.
Coding decision scenarios
Pattern scenarios for this code’s structure — decision rules, not clinical cases
Documentation: The provider documents the condition in the terms of this code’s title and records no further detail.
Coding question: Is a more specific sibling code supportable?
Path: Review the specific siblings in this subcategory and what each requires the record to state.
Reason: A more specific code needs documentation of the distinguishing element; without it the unspecified code is appropriate, and a provider query is the route to specificity (Guidelines I.A.9.b, I.B.18).
Documentation: The record documents the condition on one side only.
Coding question: Which code in this family applies?
Path: Select the sibling code for the documented side.
Reason: Laterality is assigned from the documented side; the unspecified-side code is for records that state no side (Guidelines I.B.13).
ReviewH31.321 · right, H31.322 · left
Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Verify Before Coding
- CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.
Relationships & Classification
MedCoder structured relationships — computed from published CMS and AHRQ datasets
Other codes that name H31.329 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.
Referenced by 1 Use Additional Code instruction: H44.2A — Degenerative myopia with choroidal neovascularization (via H31.-).
These codes instruct coders to additionally report this code when it applies.
MS-DRG Grouper Relationships (FY2026)
Potential MS-DRG participation — not a DRG assignment.
FY2026 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 26 clinically related codes on its CMS exclusion list.
Named in the grouper logic of 2 MS-DRGs: DRG 124 (MDC 02), DRG 125 (MDC 02).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Clinical classification (AHRQ CCSR):EYE005 — Retinal and vitreous conditions (default).
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Related Codes
Same clinical process (MS-DRG)
Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.
H31.302 — Unspecified choroidal hemorrhage, left eye, H31.303 — Unspecified choroidal hemorrhage, bilateral, H31.309 — Unspecified choroidal hemorrhage, unspecified eye, H31.311 — Expulsive choroidal hemorrhage, right eye, H31.312 — Expulsive choroidal hemorrhage, left eye, H31.313 — Expulsive choroidal hemorrhage, bilateral, H31.319 — Expulsive choroidal hemorrhage, unspecified eye, 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, H31.409 — Unspecified choroidal detachment, unspecified eye, H31.411 — Hemorrhagic choroidal detachment, right eye, H31.412 — Hemorrhagic choroidal detachment, left eye, H31.413 — Hemorrhagic choroidal detachment, bilateral, H31.419 — Hemorrhagic choroidal detachment, unspecified eye, H31.421 — Serous choroidal detachment, right eye, H31.422 — Serous choroidal detachment, left eye, +5 more
Same condition, opposite side
Same category and title, differing only in which side of the body is affected.
H31.321 — Choroidal rupture, right eye (right)Compare H31.329 vs H31.321 →, H31.322 — Choroidal rupture, left eye (left)Compare H31.329 vs H31.322 →
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Retinal and vitreous conditions).
Same Index main term, other category
The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Rupture, ruptured”; these codes share that main term but sit in a different category of the Tabular List.
A52.01 — Syphilitic aneurysm of aorta (aorta, aortic, syphilitic), A52.05 — Other cerebrovascular syphilis (brain, aneurysm, syphilitic), B51.0 — Plasmodium vivax malaria with rupture of spleen (spleen, due to P. vivax malaria), D73.5 — Infarction of spleen (spleen, spontaneous), H44.89 — Other disorders of globe (globe, nontraumatic), H72.9 — Unspecified perforation of tympanic membrane (tympanum, tympanic), I07.8 — Other rheumatic tricuspid valve diseases (tricuspid), I23.0 — Hemopericardium as current complication following acute myocardial infarction (cardiac, with hemopericardium), I23.3 — Rupture of cardiac wall without hemopericardium as current complication following acute myocardial infarction (cardiac), I23.4 — Rupture of chordae tendineae as current complication following acute myocardial infarction (chordae tendineae NEC, following acute myocardial infarction), I23.5 — Rupture of papillary muscle as current complication following acute myocardial infarction (papillary muscle NEC, following acute myocardial infarction), I28.8 — Other diseases of pulmonary vessels (pulmonary, vein), I34.89 — Other nonrheumatic mitral valve disorders (mitral), I35.8 — Other nonrheumatic aortic valve disorders (aorta, aortic, valve or cusp), I37.8 — Other nonrheumatic pulmonary valve disorders (pulmonary, valve), I40.9 — Acute myocarditis, unspecified (cardiac, infectional), I51.1 — Rupture of chordae tendineae, not elsewhere classified (chordae tendineae NEC), I51.2 — Rupture of papillary muscle, not elsewhere classified (papillary muscle NEC), I60.6 — Nontraumatic subarachnoid hemorrhage from other intracranial arteries (circle of Willis), I60.8 — Other nontraumatic subarachnoid hemorrhage (meningeal artery), +148 more
Lab tests where this diagnosis supports Medicare coverage (NCD)
Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.
Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)
Contextual Map
Every relationship of H31.329 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Run H31.329 with this related code in Claim Check
Hierarchy
- H00-H59 — Chapter 7: Diseases of the Eye and Adnexa (H00-H59) (H00-H59)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- H30-H36 — Disorders of choroid and retina[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Referenced by Use Additional Code instructions
- H44.2A — Degenerative myopia with choroidal neovascularization[Use Additional Code](via H31.-): “code for any associated choroid disorders (H31.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Clinical classification (CCSR)
- EYE005 — Retinal and vitreous conditions[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
MS-DRG Grouper
- CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2026
- DRG 124 — OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT[MS-DRG]: “OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT (MDC 02)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
- DRG 125 — OTHER DISORDERS OF THE EYE WITHOUT MCC[MS-DRG]: “OTHER DISORDERS OF THE EYE WITHOUT MCC (MDC 02)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
MDC crossing
- MDC 02 — Diseases and Disorders of the Eye[MDC crossing]: “Diseases and Disorders of the Eye — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1,200 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
Nearest codes (40)
- H31 — Other disorders of choroid[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- H31.129 — Diffuse secondary atrophy of choroid, unspecified eye[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- H31.2 — Hereditary choroidal dystrophy[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- H31.20 — Hereditary choroidal dystrophy, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- H31.21 — Choroideremia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- H31.22 — Choroidal dystrophy (central areolar) (generalized) (peripapillary)[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- H31.23 — Gyrate atrophy, choroid[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- H31.29 — Other hereditary choroidal dystrophy[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 32 more
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, title, tabular notes and index terms Official source data
- CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
- Inpatient payment groups Official source data
- CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder structured relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
Cite this page
Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.
MedCoder.ai. "H31.329 — Choroidal rupture, unspecified eye." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/h31.329-choroidal-rupture-unspecified-eye
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionChoroidal rupture, unspecified eye
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to H31.329 in its code family, with their registry titles.
- H31.319 — Expulsive choroidal hemorrhage, unspecified eye
- H31.32 — Choroidal rupture
- H31.321 — Choroidal rupture, right eye
- H31.322 — Choroidal rupture, left eye
- H31.323 — Choroidal rupture, bilateral
- H31.4 — Choroidal detachment
- H31.40 — Unspecified choroidal detachment
- H31.401 — Unspecified choroidal detachment, right eye
- H31.402 — Unspecified choroidal detachment, left eye
- H31.403 — Unspecified choroidal detachment, bilateral