2027 ICD-10-CM Diagnosis Code H31.012Macula scars of posterior pole (postinflammatory) (post-traumatic), left eye

ICD-10-CM Codes›H00–H59›H30-H36›H31

ICD-10-CM H31.012
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

H31.012 is a billable ICD-10-CM diagnosis code for macula scars of posterior pole (postinflammatory) (post-traumatic), 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 scar of macula of left eye following trauma. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Retinal and vitreous conditions.

Code Identity

ICD-10-CM Code
H31.012
Billable Status
Yes — Valid for Submission
Code Describes
Macula scars of posterior pole (postinflammatory) (post-traumatic), left eye
Short Description
Macula scars of posterior pole (post-traumatic), left eye
Parent Code
H31.01
Macula scars of posterior pole (postinflammatory) (post-traumatic)

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH30-H36Disorders of choroid and retina
CategoryH31Other disorders of choroid
This CodeH31.012Macula scars of posterior pole (postinflammatory) (post-traumatic), left eye

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Scar of macula of left eye following trauma
  • Scar of posterior pole of retina of left eye
  • Scarred macula
  • Scarred macula of left eye
  • Scarring after injury

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to H31.012: its own notes plus those printed at H31.01, H31.0, and Chapter 7. A note printed at a category, block or chapter applies to every code under it.

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From H31.01 Macula scars of posterior pole (postinflammatory) (post-traumatic) applies to 4 codes
  • postprocedural choriorentinal scar (H59.81-)

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 H31.0 Chorioretinal scars applies to 16 codes
  • postsurgical chorioretinal scars (H59.81-)
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.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name H31.012, its category, or a range that includes it.

Use Additional Code 1

These codes say to use an additional code from the note, and H31.012 is one of the codes named.

  • H44.2A Degenerative myopia with choroidal neovascularization
    code for any associated choroid disorders (H31.-) names H31.-, which includes this code

Clinical ClassificationClinical

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

CCSR EYE005
Retinal and vitreous conditions
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 H31.012 to ICD-9-CMHistory

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

ICD-9-CM
363.32 Macular scars NEC
Approximate The match is approximate rather than exact.
ICD-9-CM
363.33 Posterior pole scar NEC
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 H31.012Overview

Is H31.012 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report macula scars of posterior pole (postinflammatory) (post-traumatic), left eye on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does H31.012 group to?

When macula scars of posterior pole (postinflammatory) (post-traumatic), 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.

Can H31.012 be reported with a code from H59.81?

Not as a rule. The Excludes1 note at H31.01, which applies to H31.012, lists "postprocedural choriorentinal scar (H59.81-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

What is the ICD-9 equivalent of H31.012?

Under the General Equivalence Mappings, macula scars of posterior pole (postinflammatory) (post-traumatic), left eye converts to ICD-9-CM 363.32 (macular scars NEC) and 363.33 (posterior pole scar NEC). The mapping is approximate, so confirm the match fits the documentation.