2026 ICD-10-CM Diagnosis Code H30.043Focal chorioretinal inflammation, macular or paramacular, bilateral

ICD-10-CM Codes›H00–H59›H30-H36›H30

ICD-10-CM H30.043
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

H30.043 is a billable ICD-10-CM diagnosis code for focal chorioretinal inflammation, macular or paramacular, bilateral. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 124 through 125. 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
H30.043
Billable Status
Yes — Valid for Submission
Code Describes
Focal chorioretinal inflammation, macular or paramacular, bilateral
Short Description
Focal chorioretin inflam, macular or paramacular, bilateral
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 CodeH30.043Focal chorioretinal inflammation, macular or paramacular, bilateral

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Bilateral focal chorioretinitis
  • Bilateral focal choroiditis
  • Bilateral macular focal chorioretinitis
  • Bilateral macular focal choroiditis
  • Bilateral macular focal retinitis
  • Bilateral posterior pole focal retinitis
  • Focal retinitis of posterior pole of left eye
  • Focal retinitis of posterior pole of right eye
  • Left focal chorioretinitis
  • Left macular focal retinitis
  • Macular focal choroiditis
  • Macular focal retinitis
  • Paramacular focal retinitis AND retinochoroiditis
  • Right focal chorioretinitis
  • Right macular focal retinitis

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

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.

Read the full article at MedlinePlus

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

Convert H30.043 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 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About H30.043Overview

Is H30.043 (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, bilateral on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does H30.043 group to?

When focal chorioretinal inflammation, macular or paramacular, bilateral is the principal diagnosis on an inpatient stay, it groups to MS-DRG 124, 125, with relative weights from 0.7678 to 1.3231 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of H30.043?

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

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.