Skip to main content
ICD-10/H34.8311

H34.8311 ICD-10-CM Code: Tributary (branch) retinal vein occlusion, right eye, with retinal neovascularization

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 123 — NEUROLOGICAL EYE DISORDERS (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.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 298 — Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Official Registry Overview & Definition

Tributary (branch) retinal vein occlusion, right eye, with retinal neovascularization is a billable ICD-10-CM diagnosis code (H34.8311).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for H34.8311 in the official ICD-10-CM tabular list.

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).

Change history

  • FY2017 — 2016-10-01
    Added to the code set
    Tributary (branch) retinal vein occlusion, right eye, with retinal neovascularization
    FY2017 changes

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Contextual Map

Every relationship of H34.8311 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.

Hierarchy

  • H00-H59 — Chapter 7: Diseases of the Eye and Adnexa (H00-H59) (H00-H59) [Hierarchy]
  • H30-H36 — Disorders of choroid and retina [Hierarchy]

Referenced by Excludes2 notes

  • I74 — Arterial embolism and thrombosis [Excludes2](via H34.-): “ophthalmic embolism and thrombosis (H34.-)” · check together

Clinical classification (CCSR)

  • EYE005 — Retinal and vitreous conditions [CCSR]

Risk adjustment (CMS-HCC)

  • HCC 298 — Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage [CMS-HCC]

Potential MS-DRG

  • DRG 123 — NEUROLOGICAL EYE DISORDERS [MS-DRG]: “NEUROLOGICAL EYE DISORDERS (MDC 02)”

MDC crossing · procedures (1200)

  • 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.”
  • 039S0ZX — Drainage of Right Temporal Artery, Open Approach, Diagnostic [Same-MDC procedure]: “Drainage of Right Temporal Artery, Open Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
  • 039S4ZX — Drainage of Right Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic [Same-MDC procedure]: “Drainage of Right Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
  • 039T0ZX — Drainage of Left Temporal Artery, Open Approach, Diagnostic [Same-MDC procedure]: “Drainage of Left Temporal Artery, Open Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
  • 039T4ZX — Drainage of Left Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic [Same-MDC procedure]: “Drainage of Left Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
  • 03BS0ZX — Excision of Right Temporal Artery, Open Approach, Diagnostic [Same-MDC procedure]: “Excision of Right Temporal Artery, Open Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
  • and 1195 more

Nearest codes (40)

  • H34 — Retinal vascular occlusions [Sibling]
  • H34.8 — Other retinal vascular occlusions [Sibling]
  • H34.81 — Central retinal vein occlusion [Sibling]
  • H34.811 — Central retinal vein occlusion, right eye [Sibling]
  • H34.8110 — Central retinal vein occlusion, right eye, with macular edema [Sibling]
  • H34.8111 — Central retinal vein occlusion, right eye, with retinal neovascularization [Sibling]
  • H34.8112 — Central retinal vein occlusion, right eye, stable [Sibling]
  • H34.812 — Central retinal vein occlusion, left eye [Sibling]
  • and 32 more

Change history

  • FY2017 — Added to the code set [Change history]

Referenced by Other Codes

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.

Potential MS-DRG Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 1 MS-DRG: DRG 123 (MDC 02).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Official ICD-10-CM tabular notes on other codes that name H34.8311 or its code family.

1 Excludes2 notes: I74 (via H34.-).

Frequently Asked Questions (FAQ) & Clinical Guidance

Does H34.8311 require a 7th character?

Yes. One of the following 7th characters is to be assigned to codes in subcategory H34.83 to designate the severity of the occlusion:.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to H34.8311 in its code family, with their registry titles.

  • H34.823 — Venous engorgement, bilateral
  • H34.829 — Venous engorgement, unspecified eye
  • H34.83 — Tributary (branch) retinal vein occlusion
  • H34.831 — Tributary (branch) retinal vein occlusion, right eye
  • H34.8310 — Tributary (branch) retinal vein occlusion, right eye, with macular edema
  • H34.8312 — Tributary (branch) retinal vein occlusion, right eye, stable
  • H34.832 — Tributary (branch) retinal vein occlusion, left eye
  • H34.8320 — Tributary (branch) retinal vein occlusion, left eye, with macular edema
  • H34.8321 — Tributary (branch) retinal vein occlusion, left eye, with retinal neovascularization
  • H34.8322 — Tributary (branch) retinal vein occlusion, left eye, stable

View all codes in the H34 family