2024 ICD-10-CM Diagnosis Code H35.53

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

• Bilateral degeneration of macula
• Bilateral fundus flavimaculatus of eyes
• Cone dystrophy
• Degenerative disorder of macula of left eye
• Degenerative disorder of macula of right eye
• Fundus flavimaculatus
• Hereditary retinal dystrophy primarily involving sensory retina
• Hyaline retinal dystrophy
• Progressive cone dystrophy
• Progressive rod dystrophy
• Retinitis pigmentosa-deafness syndrome
• Retinitis pigmentosa-deafness syndrome
• Retinitis pigmentosa-deafness-ataxia syndrome
• Rod dystrophy
• Sensory retinal dystrophy
• Sorsby pseudoinflammatory fundus dystrophy
• Usher syndrome type 1
• Usher syndrome type 2

Clinical Information

• Cone Dystrophy

  a general term which describes a group of rare eye disorders that affect the cone cells of the retina. cone dystrophy can cause a variety of symptoms including decreased visual clarity or acuity when looking straight ahead (central vision), a reduced ability to see colors, and an increased sensitivity to light (photophobia).

• Usher Syndrome Type 1

  a syndrome characterized by congenital, bilateral, severe sensorineural hearing loss, abnormalities in the vestibular system, and adolescent-onset retinitis pigmentosa.

• Usher Syndrome Type 2

  a syndrome characterized by congenital, bilateral sensorineural hearing loss that is mild to moderate in the low frequencies and severe to profound in the higher frequencies, no abnormalities in the vestibular system, and retinitis pigmentosa.

• Usher Syndrome Type 2C|USH2C

  an autosomal recessive sub-type of usher syndrome caused by homozygous or compound heterozygous mutation(s) in the adgrv1 gene, encoding adhesion g protein-coupled receptor v1. it may also result from biallelic digenic mutation(s) in adgrv1 and pdzd7, which encodes pdz domain-containing protein 7.

H35.53 is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
124	OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT	02	1.3219
125	OTHER DISORDERS OF THE EYE WITHOUT MCC	02	0.7975

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Convert H35.53 to ICD-9-CM

• ICD-9-CM Code: 362.75 - Sensory retina dystrophy

Patient Education

Retinal Disorders

The retina is a layer of tissue in the back of your eye that senses light and sends images to your brain. In the center of this nerve tissue is the macula. It provides the sharp, central vision needed for reading, driving and seeing fine detail.

Retinal disorders affect this vital tissue. They can affect your vision, and some can be serious enough to cause blindness. Examples are:

• Macular degeneration - a disease that destroys your sharp, central vision
• Diabetic eye disease
• Retinal detachment - a medical emergency, when the retina is pulled away from the back of the eye
• Retinoblastoma - cancer of the retina. It is most common in young children.
• Macular pucker - scar tissue on the macula
• Macular hole - a small break in the macula that usually happens to people over 60
• Floaters - cobwebs or specks in your field of vision

NIH: National Eye Institute

[Learn More in MedlinePlus]

Stargardt macular degeneration

Stargardt macular degeneration is a genetic eye disorder that causes progressive vision loss. This disorder affects the retina, the specialized light-sensitive tissue that lines the back of the eye. Specifically, Stargardt macular degeneration affects a small area near the center of the retina called the macula. The macula is responsible for sharp central vision, which is needed for detailed tasks such as reading, driving, and recognizing faces. In most people with Stargardt macular degeneration, a fatty yellow pigment (lipofuscin) builds up in cells underlying the macula. Over time, the abnormal accumulation of this substance can damage cells that are critical for clear central vision. In addition to central vision loss, people with Stargardt macular degeneration have problems with night vision that can make it difficult to navigate in low light. Some affected individuals also have impaired color vision. The signs and symptoms of Stargardt macular degeneration typically appear in late childhood to early adulthood and worsen over time.

[Learn More in MedlinePlus]

Code History

• FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.