2027 ICD-10-CM Diagnosis Code H34.231Retinal artery branch occlusion, right eye
ICD-10-CM Codes›H00–H59›H30-H36›H34
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Chronic Condition
H34.231 is a billable ICD-10-CM diagnosis code for retinal artery branch occlusion, right 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. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 46 closely related codes. Coders also document this condition as arterial retinal branch occlusion. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Retinal and vitreous conditions.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Arterial retinal branch occlusion
- Cilioretinal artery occlusion
- Occlusion of right branch retinal artery
- Occlusion of right cilioretinal artery
- Retinal artery occlusion
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to H34.231: its own notes plus those printed at H34 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.
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.
- 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.
- 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 H34.231, its category, or a range that includes it.
Excludes2 2
These codes carry an Excludes2 note naming H34.231: its condition is not part of those codes, and both may be reported when the patient has both.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
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 H34.231 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About H34.231Overview
What is the ICD-10 code for retinal artery branch occlusion, right eye?
The ICD-10-CM code for retinal artery branch occlusion, right eye is H34.231 (sometimes written as H34231). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is H34.231 (Retinal artery branch occlusion) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report retinal artery branch occlusion, right eye on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does H34.231 group to?
When retinal artery branch occlusion, right 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.
Is H34.231 a CC or MCC?
CMS lists H34.231 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 46 closely related codes in its exclusion list.
Can H34.231 be reported with G45.3?
Not as a rule. The Excludes1 note at H34, which applies to H34.231, lists "amaurosis fugax (G45.3)". 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).
