2020 ICD-10-CM Diagnosis Code H35.38

Toxic maculopathy

    2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
  • H35.38 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
  • The 2020 edition of ICD-10-CM H35.38 became effective on October 1, 2019.
  • This is the American ICD-10-CM version of H35.38 - other international versions of ICD-10 H35.38 may differ.
Use Additional
Use Additional Help
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
  • code for adverse effect, if applicable, to identify drug (T36-T50
    ICD-10-CM Range T36-T50

    Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances

    Code First
    • , for adverse effects, the nature of the adverse effect, such as:
    • adverse effect NOS (T88.7)
    • aspirin gastritis (K29.-)
    • blood disorders (D56-D76)
    • contact dermatitis (L23-L25)
    • dermatitis due to substances taken internally (L27.-)
    • nephropathy (N14.0-N14.2)
    Includes
    • adverse effect of correct substance properly administered
    • poisoning by overdose of substance
    • poisoning by wrong substance given or taken in error
    • underdosing by (inadvertently) (deliberately) taking less substance than prescribed or instructed
    Note
    • The drug giving rise to the adverse effect should be identified by use of codes from categories T36-T50 with fifth or sixth character 5.
    Type 1 Excludes
    • toxic reaction to local anesthesia in pregnancy (O29.3-)
    Type 2 Excludes
    • abuse and dependence of psychoactive substances (F10-F19)
    • abuse of non-dependence-producing substances (F55.-)
    • drug reaction and poisoning affecting newborn (P00-P96)
    • pathological drug intoxication (inebriation) (F10-F19)
    Use Additional
    • code(s) to specify:
    • manifestations of poisoning
    • underdosing or failure in dosage during medical and surgical care (Y63.6, Y63.8-Y63.9)
    • underdosing of medication regimen (Z91.12-, Z91.13-)
    • T36 Poisoning by, adverse effect of and unde...
    • T37 Poisoning by, adverse effect of and unde...
    • T38 Poisoning by, adverse effect of and unde...
    • T39 Poisoning by, adverse effect of and unde...
    • T40 Poisoning by, adverse effect of and unde...
    • T41 Poisoning by, adverse effect of and unde...
    • T42 Poisoning by, adverse effect of and unde...
    • T43 Poisoning by, adverse effect of and unde...
    • T44 Poisoning by, adverse effect of and unde...
    • T45 Poisoning by, adverse effect of and unde...
    • T46 Poisoning by, adverse effect of and unde...
    • T47 Poisoning by, adverse effect of and unde...
    • T48 Poisoning by, adverse effect of and unde...
    • T49 Poisoning by, adverse effect of and unde...
    • T50 Poisoning by, adverse effect of and unde...
    with fifth or sixth character 5)
Code First
Code First Help
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
  • poisoning due to drug or toxin, if applicable (
    ICD-10-CM Diagnosis Code T36

    Poisoning by, adverse effect of and underdosing of systemic antibiotics

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Type 1 Excludes
    • antineoplastic antibiotics (T45.1-)
    • locally applied antibiotic NEC (T49.0)
    • topically used antibiotic for ear, nose and throat (T49.6)
    • topically used antibiotic for eye (T49.5)
    T36
    -
    ICD-10-CM Diagnosis Code T65

    Toxic effect of other and unspecified substances

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    T65
    with fifth or sixth character 1-4 or 6)
The following code(s) above H35.38 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to H35.38:
  • H00-H59
    2020 ICD-10-CM Range H00-H59

    Diseases of the eye and adnexa

    Note
    • Use an external cause code following the code for the eye condition, if applicable, to identify the cause of the eye condition
    Type 2 Excludes
    • certain conditions originating in the perinatal period (P04-P96)
    • certain infectious and parasitic diseases (A00-B99)
    • complications of pregnancy, childbirth and the puerperium (O00-O9A)
    • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
    • diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)
    • endocrine, nutritional and metabolic diseases (E00-E88)
    • injury (trauma) of eye and orbit (S05.-)
    • injury, poisoning and certain other consequences of external causes (S00-T88)
    • neoplasms (C00-D49)
    • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
    • syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)
    Diseases of the eye and adnexa
  • H35
    ICD-10-CM Diagnosis Code H35

    Other retinal disorders

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Type 2 Excludes
    Other retinal disorders
Code History
  • 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

Diagnosis Index entries containing back-references to H35.38:
  • Degeneration, degenerative
    • macula, macular (acquired) (age-related) (senile) H35.30
      ICD-10-CM Diagnosis Code H35.30

      Unspecified macular degeneration

        2016 2017 2018 2019 2020 Billable/Specific Code Adult Dx (15-124 years)
      Applicable To
      • Age-related macular degeneration
      • toxic H35.38-

ICD-10-CM Codes Adjacent To H35.38
H35.36 Drusen (degenerative) of macula
H35.361 …… right eye
H35.362 …… left eye
H35.363 …… bilateral
H35.369 …… unspecified eye
H35.37 Puckering of macula
H35.371 …… right eye
H35.372 …… left eye
H35.373 …… bilateral
H35.379 …… unspecified eye
H35.38 Toxic maculopathy
H35.381 …… right eye
H35.382 …… left eye
H35.383 …… bilateral
H35.389 …… unspecified eye
H35.4 Peripheral retinal degeneration
H35.40 Unspecified peripheral retinal degeneration
H35.41 Lattice degeneration of retina
H35.411 …… right eye
H35.412 …… left eye
H35.413 …… bilateral

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