H35.3 ICD-10-CM Code: Degeneration of macula and posterior pole
Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.
Official Registry Overview & Definition
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for H35.3 in the official ICD-10-CM tabular list.
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 H35.3 vs E08.311 →
Change history
No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.
Verify Before Coding
- Not billable as written — a more specific code is required: H35.30, H35.3110, H35.3111, H35.3112, H35.3113.
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 H35.3 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]
Nearest codes (40)
- H35 — Other retinal disorders [Sibling]
- H35.15 — Retinopathy of prematurity, stage 4 [Sibling]
- H35.151 — Retinopathy of prematurity, stage 4, right eye [Sibling]
- H35.152 — Retinopathy of prematurity, stage 4, left eye [Sibling]
- H35.153 — Retinopathy of prematurity, stage 4, bilateral [Sibling]
- H35.159 — Retinopathy of prematurity, stage 4, unspecified eye [Sibling]
- H35.16 — Retinopathy of prematurity, stage 5 [Sibling]
- H35.161 — Retinopathy of prematurity, stage 5, right eye [Sibling]
- and 32 more
Frequently Asked Questions (FAQ) & Clinical Guidance
Can H35.3 be billed directly?
No. H35.3 (Degeneration of macula and posterior pole) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to H35.3 in its code family, with their registry titles.
- H35.2 — Other non-diabetic proliferative retinopathy
- H35.20 — Other non-diabetic proliferative retinopathy, unspecified eye
- H35.21 — Other non-diabetic proliferative retinopathy, right eye
- H35.22 — Other non-diabetic proliferative retinopathy, left eye
- H35.23 — Other non-diabetic proliferative retinopathy, bilateral
- H35.30 — Unspecified macular degeneration
- H35.31 — Nonexudative age-related macular degeneration
- H35.311 — Nonexudative age-related macular degeneration, right eye
- H35.3110 — Nonexudative age-related macular degeneration, right eye, stage unspecified
- H35.3111 — Nonexudative age-related macular degeneration, right eye, early dry stage