H31.423 ICD-10-CM Code: Serous choroidal detachment, bilateral

Coder workflow for H31.423

MedCoder structured workflow — derived from this code’s own official record

Before you code H31.423

1. Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: bilateral). 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).

   See the relationships section · Guide: Laterality coding →

Choose the right path

1. 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.

Consider H31.423. 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).

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

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.

Don’t confuse H31.423 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of H31.423 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• H31.429— Specificity relationship (Review)

  Overlapping diagnoses in the same category.

  Overlapping codes in the same category — the documentation decides which is the more specific fit.

  What moves you there: A record that documents no more than “Serous choroidal detachment, unspecified eye” takes H31.429; specificity in the record moves it back here.

  Full comparison: H31.423 vs H31.429 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

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 H31.423 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.

H31.312 — 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, H31.329 — Choroidal rupture, unspecified eye, 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, H31.429 — Serous choroidal detachment, unspecified eye, H31.8 — Other specified disorders of choroid, H31.9 — Unspecified disorder of choroid, +5 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Retinal and vitreous conditions).

+747 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Detachment”; these codes share that main term but sit in a different category of the Tabular List.

H33.00 — Unspecified retinal detachment with retinal break (retina, with retinal:, break), H33.01 — Retinal detachment with single break (retina, with retinal:, break, single), H33.02 — Retinal detachment with multiple breaks (retina, with retinal:, break, multiple), H33.03 — Retinal detachment with giant retinal tear (retina, with retinal:, break, giant), H33.04 — Retinal detachment with retinal dialysis (retina, with retinal:, dialysis), H33.05 — Total retinal detachment (retina, total), H33.2 — Serous retinal detachment (retina), H33.4 — Traction detachment of retina (retina, traction), H33.8 — Other retinal detachments (retina, specified NEC), H43.81 — Vitreous degeneration (vitreous), N88.8 — Other specified noninflammatory disorders of cervix uteri (cervix, annular), O71.3 — Obstetric laceration of cervix (cervix, annular, complicating delivery)

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.

Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of H31.423 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 H31.423 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

Nearest Codes in This Family

Official ICD-10-CM classifications closest to H31.423 in its code family, with their registry titles.

• H31.41 — Hemorrhagic choroidal detachment
• 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
• H31.42 — Serous choroidal detachment
• H31.421 — Serous choroidal detachment, right eye
• H31.422 — Serous choroidal detachment, left eye
• H31.429 — Serous choroidal detachment, unspecified eye
• H31.8 — Other specified disorders of choroid

View all codes in the H31 family