2020 ICD-10-CM Diagnosis Code H36

Retinal disorders in diseases classified elsewhere

    2016 2017 2018 2019 2020 Billable/Specific Code Manifestation Code
  • H36 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • The 2020 edition of ICD-10-CM H36 became effective on October 1, 2019.
  • This is the American ICD-10-CM version of H36 - other international versions of ICD-10 H36 may differ.
ICD-10-CM Coding Rules
  • H36 describes the manifestation of an underlying disease, not the disease itself.
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.
  • underlying disease, such as:
  • lipid storage disorders (
    ICD-10-CM Diagnosis Code E75
    • E75 Disorders of sphingolipid metabolism and othe...
    E75.-
    )
  • sickle-cell disorders (
    ICD-10-CM Diagnosis Code D57
    • D57 Sickle-cell disorders
      • D57.0 Hb-SS disease with crisis
        • D57.00 …… unspecified
        • D57.01 Hb-SS disease with acute chest syndrome
        • D57.02 Hb-SS disease with splenic sequestration
      • D57.1 Sickle-cell disease without crisis
      • D57.2 Sickle-cell/Hb-C disease
        • D57.20 …… without crisis
        • D57.21 Sickle-cell/Hb-C disease with crisis
          • D57.211 Sickle-cell/Hb-C disease with acute chest syn...
          • D57.212 Sickle-cell/Hb-C disease with splenic sequest...
          • D57.219 Sickle-cell/Hb-C disease with crisis, unspeci...
      • D57.3 Sickle-cell trait
      • D57.4 Sickle-cell thalassemia
        • D57.40 …… without crisis
        • D57.41 Sickle-cell thalassemia with crisis
          • D57.411 Sickle-cell thalassemia with acute chest synd...
          • D57.412 Sickle-cell thalassemia with splenic sequestr...
          • D57.419 Sickle-cell thalassemia with crisis, unspecif...
      • D57.8 Other sickle-cell disorders
        • D57.80 …… without crisis
        • D57.81 Other sickle-cell disorders with crisis
          • D57.811 Other sickle-cell disorders with acute chest ...
          • D57.812 Other sickle-cell disorders with splenic sequ...
          • D57.819 Other sickle-cell disorders with crisis, unsp...
    D57.-
    )
Type 1 Excludes
Type 1 Excludes Help
A type 1 excludes note is a pure excludes. It means "not coded here". A type 1 excludes note indicates that the code excluded should never be used at the same time as H36. A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • arteriosclerotic retinopathy (
    ICD-10-CM Diagnosis Code H35.0

    Background retinopathy and retinal vascular changes

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Code Also
    • any associated hypertension (I10.-)
    H35.0-
    )
  • diabetic retinopathy (
    ICD-10-CM Diagnosis Code E08.3

    Diabetes mellitus due to underlying condition with ophthalmic complications

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    E08.3-
    ,
    ICD-10-CM Diagnosis Code E09.3

    Drug or chemical induced diabetes mellitus with ophthalmic complications

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    E09.3-
    ,
    ICD-10-CM Diagnosis Code E10.3

    Type 1 diabetes mellitus with ophthalmic complications

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    E10.3-
    ,
    ICD-10-CM Diagnosis Code E11.3

    Type 2 diabetes mellitus with ophthalmic complications

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    E11.3-
    ,
    ICD-10-CM Diagnosis Code E13.3

    Other specified diabetes mellitus with ophthalmic complications

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    E13.3-
    )
The following code(s) above H36 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 H36:
  • 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
Approximate Synonyms
  • Proliferative retinopathy due to sickle cell disease
  • Retinal dystrophy
  • Retinal dystrophy due to systemic disorder
  • Retinal dystrophy in cerebroretinal lipidosis
  • Sickle cell proliferative retinopathy
  • Sickle cell retinopathy
  • Sickle cell retinopathy (eye condition)
ICD-10-CM H36 is grouped within Diagnostic Related Group(s) (MS-DRG v37.0):
  • 124 Other disorders of the eye with mcc
  • 125 Other disorders of the eye without mcc

Convert H36 to ICD-9-CM

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
ICD-10-CM Codes Adjacent To H36
H35.73 Hemorrhagic detachment of retinal pigment epithelium
H35.731 …… right eye
H35.732 …… left eye
H35.733 …… bilateral
H35.739 …… unspecified eye
H35.8 Other specified retinal disorders
H35.81 Retinal edema
H35.82 Retinal ischemia
H35.89 Other specified retinal disorders
H35.9 Unspecified retinal disorder
H36 Retinal disorders in diseases classified elsewhere
H40 Glaucoma
H40.0 Glaucoma suspect
H40.00 Preglaucoma, unspecified
H40.001 …… right eye
H40.002 …… left eye
H40.003 …… bilateral
H40.009 …… unspecified eye
H40.01 Open angle with borderline findings, low risk
H40.011 …… right eye
H40.012 …… left eye

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