1. ICD-10-CM Codes
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2. H00-H59 Diseases of the eye and adnexa
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3. H30-H36 Disorders of choroid and retina
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4. H35- Other retinal disorders
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5. 2021 ICD-10-CM Diagnosis Code H35.1

2021 ICD-10-CM Diagnosis Code H35.1

Retinopathy of prematurity

2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code

• H35.1 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
• The 2021 edition of ICD-10-CM H35.1 became effective on October 1, 2020.
• This is the American ICD-10-CM version of H35.1 - other international versions of ICD-10 H35.1 may differ.

• A bilateral retinopathy characterized by neovascularization, scarring, retinal detachment, and eventually blindness. It may be mild or severe. It occurs in babies born prematurely. Causes include oxygen toxicity and hypoxia.
• A bilateral retinopathy occurring in premature infants treated with excessively high concentrations of oxygen, characterized by vascular dilatation, proliferation, and tortuosity, edema, and retinal detachment, with ultimate conversion of the retina into a fibrous mass that can be seen as a dense retrolental membrane. Usually growth of the eye is arrested and may result in microophthalmia, and blindness may occur. (Dorland, 27th ed)
• Bilateral retinopathy typically occurring in premature infants treated with high concentrations of oxygen; characterized by vascular dilation, proliferation, and tortuosity, edema, and retinal detachment with ultimate conversion of the retina into a fibrous mass; usually growth of the eye is arrested and may result in microophthalmia; blindness may occur.

• 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
• 2017 (effective 10/1/2016): No change
• 2018 (effective 10/1/2017): No change
• 2019 (effective 10/1/2018): No change
• 2020 (effective 10/1/2019): No change
• 2021 (effective 10/1/2020): No change

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.