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H34.819 ICD-10-CM Code: Central retinal vein occlusion, unspecified eye

Compare with another codeCheck this code on a claim

Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Coding at a Glance

7th character
Required — see the character table on this page
Tabular directives
1 Excludes1

Not billable · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

Excludes1Never report with this code

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for H34.819 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on H34.819 itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from H34

7th Character Guide

"One of the following 7th characters is to be assigned to codes in subcategory H34.81 to designate the severity of the occlusion:"

  • 0 — with macular edema
  • 1 — with retinal neovascularization
  • 2 — stable

Variant codes in this family

H34.8190, H34.8191, H34.8192

Character meanings are CMS's official 7th-character extensions for this family, as carried in each variant code's official description; variant codes are registry rows. The explanation of how the encounter character is assigned is MedCoder editorial, distinct from the official content above it.

Coder workflow for H34.819

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

Before you code H34.819

  1. H34.819 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewH34.8190, H34.8191, H34.8192

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. Unspecified does not mean incorrect. When the record gives no greater specificity, H34.819 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).

    ReviewH34.811, H34.812, H34.813

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

  3. A 7th character is required in this family. Confirm the documentation supports the character assigned — its meaning in this family is defined in the official instruction. H34.819 is not valid without one. The official 7th-character definitions for this family are quoted in the guide.

    See the 7th Character Guide

  4. 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).

    ReviewH34.811 · right, H34.812 · left

    Guide: Laterality coding →

  5. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with H34.819. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support one of the more specific codes beneath H34.819?
    Yes → Select that code and continue the checks below on its own page.
    No → H34.819 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewH34.8190, H34.8191, H34.8192

  2. Does the record document the detail a more specific sibling code needs?
    Yes → Review the specific siblings in this subcategory.
    No → Continue — H34.819 is appropriate when the documentation goes no further.

    ReviewH34.811, H34.812, H34.813

  3. Does the documentation support a condition named in H34.819’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewG45.3

  4. 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.

    ReviewH34.811 · right, H34.812 · left

  5. Does the documentation support one of this family’s 7th-character values?
    Yes → Assign the matching 7th character; the variant codes are in the 7th Character Guide.
    No → The code is invalid without its 7th character — query for the missing element.

Consider H34.819. 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).
7th-character basis
The documented element this family’s 7th character records (see the official definitions in the 7th Character Guide).
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.

Official instructions as workflow

  • Excludes1 — check before selecting H34.819(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with H34.819: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareG45.3

    See the official tabular notes · Guidelines I.A.12.a

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).

ReviewH34.811, H34.812, H34.813

Documentation: Both the condition H34.819 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewG45.3

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).

ReviewH34.811 · right, H34.812 · 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.

Don’t confuse H34.819 with…

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

The codes most likely to be picked instead of H34.819 — 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.

  • G45.3— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of amaurosis fugax moves the case to G45.3; the two are not reported together unless documented as unrelated.

    Full comparison: H34.819 vs G45.3 →

  • H34.811— Laterality relationship (Review)

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

    The same condition on the other side; the documented side decides, and a bilateral code, where one exists, replaces the pair when both sides are documented.

    What moves you there: A documented right side moves the case to H34.811.

    Full comparison: H34.819 vs H34.811 →

  • H34.812— Laterality relationship (Review)

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

    The same condition on the other side; the documented side decides, and a bilateral code, where one exists, replaces the pair when both sides are documented.

    What moves you there: A documented left side moves the case to H34.812.

    Full comparison: H34.819 vs H34.812 →

  • H34.8190— Encounter relationship (Review)

    Same underlying diagnosis, different encounter phase.

    The same diagnosis at a different phase of care; one encounter takes one 7th character.

    What moves you there: Documentation of a with macular edema moves the case to H34.8190.

    Full comparison: H34.819 vs H34.8190 →

  • H34.8191— Encounter relationship (Review)

    Same underlying diagnosis, different encounter phase.

    The same diagnosis at a different phase of care; one encounter takes one 7th character.

    What moves you there: Documentation of a with retinal neovascularization moves the case to H34.8191.

    Full comparison: H34.819 vs H34.8191 →

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.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Central retinal vein occlusion, unspecified eye is a non-billable ICD-10-CM category code (H34.819). A more specific billable subcode must be selected for claims submission.

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

  • Not billable as written — a more specific code is required: H34.8190, H34.8191, H34.8192.
  • Requires a 7th character. "One of the following 7th characters is to be assigned to codes in subcategory H34.81 to designate the severity of the occlusion:" Options: H34.8190, H34.8191, H34.8192

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-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name H34.819 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 Excludes2 note: I74 — Arterial embolism and thrombosis (via H34.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

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 condition, opposite side

Same category and title, differing only in which side of the body is affected.

H34.811 — Central retinal vein occlusion, right eye (right)Compare H34.819 vs H34.811 →, H34.812 — Central retinal vein occlusion, left eye (left)Compare H34.819 vs H34.812 →

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 “Occlusion, occluded”; these codes share that main term but sit in a different category of the Tabular List.

G91.1 — Obstructive hydrocephalus (ventricle NEC), I24.0 — Acute coronary thrombosis not resulting in myocardial infarction (artery, coronary), I25.2 — Old myocardial infarction (coronary, healed or old), I25.82 — Chronic total occlusion of coronary artery (coronary, total), I63.00 — Cerebral infarction due to thrombosis of unspecified precerebral artery (artery, precerebral, with infarction, due to, thrombosis), I63.01 — Cerebral infarction due to thrombosis of vertebral artery (artery, vertebral, with, infarction, due to, thrombosis), I63.02 — Cerebral infarction due to thrombosis of basilar artery (artery, basilar, with, infarction, due to, thrombosis), I63.03 — Cerebral infarction due to thrombosis of carotid artery (artery, carotid, with, infarction, due to, thrombosis), I63.09 — Cerebral infarction due to thrombosis of other precerebral artery (artery, precerebral, specified NEC, with infarction, due to, thrombosis), I63.10 — Cerebral infarction due to embolism of unspecified precerebral artery (artery, precerebral, with infarction, due to, embolism), I63.11 — Cerebral infarction due to embolism of vertebral artery (artery, vertebral, with, infarction, due to, embolism), I63.12 — Cerebral infarction due to embolism of basilar artery (artery, basilar, with, infarction, due to, embolism), I63.13 — Cerebral infarction due to embolism of carotid artery (artery, carotid, with, infarction, due to, embolism), I63.19 — Cerebral infarction due to embolism of other precerebral artery (artery, precerebral, specified NEC, with infarction, due to, embolism), I63.20 — Cerebral infarction due to unspecified occlusion or stenosis of unspecified precerebral arteries (artery, precerebral, with infarction), I63.21 — Cerebral infarction due to unspecified occlusion or stenosis of vertebral arteries (artery, vertebral, with, infarction), I63.22 — Cerebral infarction due to unspecified occlusion or stenosis of basilar artery (artery, basilar, with, infarction), I63.23 — Cerebral infarction due to unspecified occlusion or stenosis of carotid arteries (artery, carotid, with, infarction), I63.29 — Cerebral infarction due to unspecified occlusion or stenosis of other precerebral arteries (artery, precerebral, specified NEC, with infarction), I63.3 — Cerebral infarction due to thrombosis of cerebral arteries (artery, brain or cerebral, with infarction, thrombosis), +71 more

Contextual Map

Every relationship of H34.819 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 H34.819 with this related code in Claim Check

Hierarchy

Referenced by Excludes2 notes

Clinical classification (CCSR)

Nearest codes (40)

Change history (2)

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Common coding questions

MedCoder editorial

Can H34.819 be billed directly?

No. H34.819 (Central retinal vein occlusion, unspecified eye) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Does H34.819 require a 7th character?

Yes. One of the following 7th characters is to be assigned to codes in subcategory H34.81 to designate the severity of the occlusion:.

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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) 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-derived 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 editorial 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.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

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. "H34.819 — Central retinal vein occlusion, unspecified eye." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/h34.819-central-retinal-vein-occlusion-unspecified-eye

Change history

  • FY2017 — October 1, 2016
    Became a non-billable header
    FY2017 changes
  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Central retinal vein occlusion, unspecified eye

Nearest Codes in This Family

Official ICD-10-CM classifications closest to H34.819 in its code family, with their registry titles.

View all codes in the H34 family