2027 ICD-10-CM Diagnosis Code H30.042Focal chorioretinal inflammation, macular or paramacular, left eye

ICD-10-CM Codes›H00–H59›H30-H36›H30

ICD-10-CM H30.042
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

H30.042 is a billable ICD-10-CM diagnosis code for focal chorioretinal inflammation, macular or paramacular, left eye. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 124 through 125. Coders also document this condition as focal retinitis of posterior pole of left eye. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Retinal and vitreous conditions and Uveitis and ocular inflammation.

Code Identity

ICD-10-CM Code
H30.042
Billable Status
Yes — Valid for Submission
Code Describes
Focal chorioretinal inflammation, macular or paramacular, left eye
Short Description
Focal chorioretin inflam, macular or paramacular, left eye
Parent Code
H30.04
Focal chorioretinal inflammation, macular or paramacular

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH30-H36Disorders of choroid and retina
CategoryH30Chorioretinal inflammation
This CodeH30.042Focal chorioretinal inflammation, macular or paramacular, left eye

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Focal retinitis of posterior pole of left eye
  • Left focal chorioretinitis
  • Left macular focal choroiditis
  • Left macular focal retinitis
  • Macular focal choroiditis
  • Macular focal retinitis

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to H30.042: its own notes plus those printed at Chapter 7. A note printed at a category, block or chapter applies to every code under it.

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Chapter 7 (H00-H59) Diseases of the eye and adnexa applies to 2,677 codes
  • 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)

Notes

General instructions on how these codes are used.

From Chapter 7 (H00-H59) Diseases of the eye and adnexa applies to 2,677 codes
  • Use an external cause code following the code for the eye condition, if applicable, to identify the cause of the eye condition

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR EYE005
Retinal and vitreous conditions
Default principal diagnosis: inpatient No · outpatient No
CCSR EYE004
Uveitis and ocular inflammation
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Retinal Disorders

Retinal disorders are conditions that affect the retina, the thin light-sensitive tissue at the back of your eye. The retina senses light and sends signals to your brain so you can see.

The full article covers:

  • What are retinal disorders?
  • What causes retinal disorders?
  • What are common retinal disorders?
  • What are the symptoms of retinal disorders?
  • How are retinal disorders diagnosed?
  • How are retinal disorders treated?
  • Can retinal disorders be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert H30.042 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
363.06 Macular focal retinitis
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About H30.042Overview

What is the ICD-10 code for focal chorioretinal inflammation, macular or paramacular, left eye?

The ICD-10-CM code for focal chorioretinal inflammation, macular or paramacular, left eye is H30.042 (sometimes written as H30042). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is H30.042 (Focal chorioretinal inflammation, macular or paramacular) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report focal chorioretinal inflammation, macular or paramacular, left eye on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does H30.042 group to?

When focal chorioretinal inflammation, macular or paramacular, left eye is the principal diagnosis on an inpatient stay, it groups to MS-DRG 125, 124, with relative weights from 0.7699 to 1.2470 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of H30.042?

Under the General Equivalence Mappings, focal chorioretinal inflammation, macular or paramacular, left eye converts to ICD-9-CM 363.06 (macular focal retinitis). The mapping is approximate, so confirm the match fits the documentation.