Version 2024

2024 ICD-10-CM Diagnosis Code H59.813

Chorioretinal scars after surgery for detachment, bilateral

ICD-10-CM Code:: H59.813
ICD-10 Code for:: Chorioretinal scars after surgery for detachment, bilateral
Is Billable?: Yes - Valid for Submission
Chronic Condition Indicator: ^[1]: Not chronic
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Code Information
Approximate Synonyms
Clinical Classification
Tabular List of Diseases and Injuries
Diagnostic Related Groups Mapping
Convert to ICD-9 Code
Patient Education
Other Codes Used Similar Conditions
Code History

Code Classification

Diseases of the eye and adnexa
(H00–H59)
- Intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified
  (H59)
  - Intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified
    (H59)

H59.813 is a billable diagnosis code used to specify a medical diagnosis of chorioretinal scars after surgery for detachment, bilateral. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

Approximate Synonyms

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

Bilateral chorioretinal scar of eyes
Bilateral postsurgical chorioretinal scar
Chorioretinal scar of left eye
Chorioretinal scar of right eye
Left postsurgical chorioretinal scar
Postsurgical chorioretinal scar
Postsurgical choroid scar
Postsurgical retinal scar
Right postsurgical chorioretinal scar
Surgical scar

Clinical Classification

Clinical Category is Postprocedural or postoperative eye complication
CCSR Category Code: EYE011
Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

H59.813 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
919	COMPLICATIONS OF TREATMENT WITH MCC	21	1.8247
920	COMPLICATIONS OF TREATMENT WITH CC	21	1.0338
921	COMPLICATIONS OF TREATMENT WITHOUT CC/MCC	21	0.6978

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 H59.813 to ICD-9-CM

ICD-9-CM Code: 997.99 - Surg compl-body syst NEC
Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Other ICD-10-CM Codes Commonly Used for Similar Conditions

Filter related codes list:

H59 Intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified.
H59.0 Disorders of the eye following cataract surgery.
H59.01 Keratopathy (bullous aphakic) following cataract surgery.
H59.011 Keratopathy (bullous aphakic) following cataract surgery, right eye.
H59.012 Keratopathy (bullous aphakic) following cataract surgery, left eye.
H59.013 Keratopathy (bullous aphakic) following cataract surgery, bilateral.
H59.019 Keratopathy (bullous aphakic) following cataract surgery, unspecified eye.
H59.02 Cataract (lens) fragments in eye following cataract surgery.
H59.021 Cataract (lens) fragments in eye following cataract surgery, right eye.
H59.022 Cataract (lens) fragments in eye following cataract surgery, left eye.
H59.023 Cataract (lens) fragments in eye following cataract surgery, bilateral.
H59.029 Cataract (lens) fragments in eye following cataract surgery, unspecified eye.
H59.03 Cystoid macular edema following cataract surgery.
H59.031 Cystoid macular edema following cataract surgery, right eye.
H59.032 Cystoid macular edema following cataract surgery, left eye.
H59.033 Cystoid macular edema following cataract surgery, bilateral.
H59.039 Cystoid macular edema following cataract surgery, unspecified eye.
H59.09 Other disorders of the eye following cataract surgery.
H59.091 Other disorders of the right eye following cataract surgery.
H59.092 Other disorders of the left eye following cataract surgery.
H59.093 Other disorders of the eye following cataract surgery, bilateral.
H59.099 Other disorders of unspecified eye following cataract surgery.
H59.1 Intraoperative hemorrhage and hematoma of eye and adnexa complicating a procedure.
H59.11 Intraoperative hemorrhage and hematoma of eye and adnexa complicating an ophthalmic procedure.
H59.111 Intraoperative hemorrhage and hematoma of right eye and adnexa complicating an ophthalmic procedure.
H59.112 Intraoperative hemorrhage and hematoma of left eye and adnexa complicating an ophthalmic procedure.
H59.113 Intraoperative hemorrhage and hematoma of eye and adnexa complicating an ophthalmic procedure, bilateral.
H59.119 Intraoperative hemorrhage and hematoma of unspecified eye and adnexa complicating an ophthalmic procedure.
H59.12 Intraoperative hemorrhage and hematoma of eye and adnexa complicating other procedure.
H59.121 Intraoperative hemorrhage and hematoma of right eye and adnexa complicating other procedure.
H59.122 Intraoperative hemorrhage and hematoma of left eye and adnexa complicating other procedure.
H59.123 Intraoperative hemorrhage and hematoma of eye and adnexa complicating other procedure, bilateral.
H59.129 Intraoperative hemorrhage and hematoma of unspecified eye and adnexa complicating other procedure.
H59.2 Accidental puncture and laceration of eye and adnexa during a procedure.
H59.21 Accidental puncture and laceration of eye and adnexa during an ophthalmic procedure.
H59.211 Accidental puncture and laceration of right eye and adnexa during an ophthalmic procedure.
H59.212 Accidental puncture and laceration of left eye and adnexa during an ophthalmic procedure.
H59.213 Accidental puncture and laceration of eye and adnexa during an ophthalmic procedure, bilateral.
H59.219 Accidental puncture and laceration of unspecified eye and adnexa during an ophthalmic procedure.
H59.22 Accidental puncture and laceration of eye and adnexa during other procedure.
H59.221 Accidental puncture and laceration of right eye and adnexa during other procedure.
H59.222 Accidental puncture and laceration of left eye and adnexa during other procedure.
H59.223 Accidental puncture and laceration of eye and adnexa during other procedure, bilateral.
H59.229 Accidental puncture and laceration of unspecified eye and adnexa during other procedure.
H59.3 Postprocedural hemorrhage, hematoma, and seroma of eye and adnexa following a procedure.
H59.31 Postprocedural hemorrhage of eye and adnexa following an ophthalmic procedure.
H59.311 Postprocedural hemorrhage of right eye and adnexa following an ophthalmic procedure.
H59.312 Postprocedural hemorrhage of left eye and adnexa following an ophthalmic procedure.
H59.313 Postprocedural hemorrhage of eye and adnexa following an ophthalmic procedure, bilateral.
H59.319 Postprocedural hemorrhage of unspecified eye and adnexa following an ophthalmic procedure.
H59.32 Postprocedural hemorrhage of eye and adnexa following other procedure.

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.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.