Name: Other retinal disorders
Creator: MedCoder.ai

Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.

Coding at a Glance

Tabular directives: 1 Excludes2

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for H35 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

diabetic retinal disorders (E08.311-E08.359, E09.311-E09.359, E10.311-E10.359, E11.311-E11.359, E13.311-E13.359) Compare H35 vs E08.311 →

Coder workflow for H35

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

Before you code H35

H35 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).
ReviewH35.0, H35.1, H35.2, H35.3, H35.4, H35.5, H35.6, H35.7, H35.8, H35.9
See the relationships section · Guide: How to choose an ICD-10-CM code →
“Other” (NEC) means the condition is specified in the record but no dedicated code captures it. Confirm the documented form is not one a sibling code names before settling on H35; if the record states no specifics at all, the unspecified sibling applies instead. “Other” codes are for documented conditions the classification gives no specific code; “unspecified” codes are for records lacking the detail (Guidelines I.A.9.a, I.A.9.b).
See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

Choose the right path

Does the documentation support one of the more specific codes beneath H35?
Yes → Select that code and continue the checks below on its own page.
No → H35 cannot be reported as written; query for the specificity its subcategory needs.
ReviewH35.0, H35.1, H35.2, H35.3, H35.4, H35.5, H35.6, H35.7, H35.8, H35.9

Consider H35. 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).
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

Excludes2 — not part of H35(1 note)
Coding workflow: The conditions named in this note are not included in H35. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
See the official tabular notes · Guidelines I.A.12.b

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

Other retinal disorders is a non-billable ICD-10-CM category code (H35). 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.

Don’t confuse H35 with…

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

The codes most likely to be picked instead of H35 — 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.

E08.311— Excludes2 relationship (Informational)
Distinct conditions — both may be reported.
A distinct condition — both may be reported when both are documented.
What moves you there: Documentation of diabetic retinal disorders adds E08.311; it is not part of this code and both may be reported when both are documented.
Full comparison: H35 vs E08.311 →
E08.359— Excludes2 relationship (Informational)
Distinct conditions — both may be reported.
A distinct condition — both may be reported when both are documented.
What moves you there: Documentation of diabetic retinal disorders adds E08.359; it is not part of this code and both may be reported when both are documented.
Full comparison: H35 vs E08.359 →
E09.311— Excludes2 relationship (Informational)
Distinct conditions — both may be reported.
A distinct condition — both may be reported when both are documented.
What moves you there: Documentation of diabetic retinal disorders adds E09.311; it is not part of this code and both may be reported when both are documented.
Full comparison: H35 vs E09.311 →
E09.359— Excludes2 relationship (Informational)
Distinct conditions — both may be reported.
A distinct condition — both may be reported when both are documented.
What moves you there: Documentation of diabetic retinal disorders adds E09.359; it is not part of this code and both may be reported when both are documented.
Full comparison: H35 vs E09.359 →
E10.311— Excludes2 relationship (Informational)
Distinct conditions — both may be reported.
A distinct condition — both may be reported when both are documented.
What moves you there: Documentation of diabetic retinal disorders adds E10.311; it is not part of this code and both may be reported when both are documented.
Full comparison: H35 vs E10.311 →
E10.359— Excludes2 relationship (Informational)
Distinct conditions — both may be reported.
A distinct condition — both may be reported when both are documented.
What moves you there: Documentation of diabetic retinal disorders adds E10.359; it is not part of this code and both may be reported when both are documented.
Full comparison: H35 vs E10.359 →

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

Not billable as written — a more specific code is required: H35.00, H35.011, H35.012, H35.013, H35.019.

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

Contextual Map

Every relationship of H35 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 H35 with these 5 related codes 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

Excludes2

E08 — Diabetes mellitus due to underlying condition[Excludes2]: “diabetic retinal disorders (E08.311-E08.359, E09.311-E09.359, E10.311-E10.359, E11.311-E11.359, E13.311-E13.359)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
E09 — Drug or chemical induced diabetes mellitus[Excludes2]: “diabetic retinal disorders (E08.311-E08.359, E09.311-E09.359, E10.311-E10.359, E11.311-E11.359, E13.311-E13.359)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
E10 — Type 1 diabetes mellitus[Excludes2]: “diabetic retinal disorders (E08.311-E08.359, E09.311-E09.359, E10.311-E10.359, E11.311-E11.359, E13.311-E13.359)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
E11 — Type 2 diabetes mellitus[Excludes2]: “diabetic retinal disorders (E08.311-E08.359, E09.311-E09.359, E10.311-E10.359, E11.311-E11.359, E13.311-E13.359)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
E13 — Other specified diabetes mellitus[Excludes2]: “diabetic retinal disorders (E08.311-E08.359, E09.311-E09.359, E10.311-E10.359, E11.311-E11.359, E13.311-E13.359)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Nearest codes (223)

H35.0 — Background retinopathy and retinal vascular changes[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
H35.00 — Unspecified background retinopathy[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
H35.01 — Changes in retinal vascular appearance[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
H35.011 — Changes in retinal vascular appearance, right eye[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
H35.012 — Changes in retinal vascular appearance, left eye[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
H35.013 — Changes in retinal vascular appearance, bilateral[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
H35.019 — Changes in retinal vascular appearance, unspecified eye[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
H35.02 — Exudative retinopathy[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
and 215 more

Change history

FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Common coding questions

Can H35 be billed directly?

No. H35 (Other retinal disorders) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

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
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. "H35 — Other retinal disorders." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/h35-other-retinal-disorders

Change history

FY2016 — October 1, 2015
In the code set at ICD-10-CM adoption
Other retinal disorders

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 H35 in its code family, with their registry titles.

H35 ICD-10-CM Code: Other retinal disorders

Coding at a Glance

Coding instructions

Excludes2 — Not Included Here

Coder workflow for H35

Before you code H35

Choose the right path

Documentation check

Official instructions as workflow

Code Overview

Don’t confuse H35 with…

Verify Before Coding

Contextual Map

Hierarchy

Excludes2

Nearest codes (223)

Change history

Common coding questions

Can H35 be billed directly?

Sources for this page

Cite this page

Change history

Nearest Codes in This Family