2027 ICD-10-CM Diagnosis Code H31.013Macula scars of posterior pole (postinflammatory) (post-traumatic), bilateral

ICD-10-CM Codes›H00–H59›H30-H36›H31

ICD-10-CM H31.013
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

H31.013 is a billable ICD-10-CM diagnosis code for macula scars of posterior pole (postinflammatory) (post-traumatic), bilateral. 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. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Retinal and vitreous conditions.

Code Identity

ICD-10-CM Code
H31.013
Billable Status
Yes — Valid for Submission
Code Describes
Macula scars of posterior pole (postinflammatory) (post-traumatic), bilateral
Short Description
Macula scars of posterior pole (post-traumatic), bilateral
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 CodeH31.013Macula scars of posterior pole (postinflammatory) (post-traumatic), bilateral

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Bilateral scar of posterior pole of retinas
  • Scar of macula of bilateral eyes following trauma
  • Scar of macula of left eye following trauma
  • Scar of macula of right eye following trauma
  • Scar of posterior pole of retina of left eye
  • Scar of posterior pole of retina of right eye
  • Scarred macula
  • Scarred macula of bilateral eyes
  • Scarred macula of left eye
  • Scarred macula of right eye
  • Scarring after injury

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to H31.013: 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 H31.013, its category, or a range that includes it.

Use Additional Code 1

These codes say to use an additional code from the note, and H31.013 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 H31.013 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 H31.013Overview

Is H31.013 a billable code?

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

What MS-DRG does H31.013 group to?

When macula scars of posterior pole (postinflammatory) (post-traumatic), bilateral 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 H31.013 be reported with a code from H59.81?

Not as a rule. The Excludes1 note at H31.01, which applies to H31.013, 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 H31.013?

Under the General Equivalence Mappings, macula scars of posterior pole (postinflammatory) (post-traumatic), bilateral 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.