2027 ICD-10-CM Diagnosis Code H34.8322Tributary (branch) retinal vein occlusion, left eye, stable
ICD-10-CM Codes›H00–H59›H30-H36›H34
- Billable — Valid for Submission
- Risk Adjusts — HCC 298
- 7th Character 2 — Stable
- Chronic Condition
H34.8322 is a billable ICD-10-CM diagnosis code for tributary (branch) retinal vein occlusion, left eye, stable. The 7th character 2 means stable. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 123. Coders also document this condition as occlusion of branch of retinal vein of left eye. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Retinal and vitreous conditions.
For Medicare Advantage risk adjustment, H34.8322 maps to CMS-HCC Category 298 (Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage) under the V28 model, adding a risk factor of about 0.336 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
H34.8322 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Occlusion of branch of retinal vein of left eye
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to H34.8322: its own notes plus those printed at H34.83, 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
7th Character
Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.
- One of the following 7th characters is to be assigned to codes in subcategory H34.83 to designate the severity of the occlusion:
- 0with macular edema
- 1with retinal neovascularization
- 2stable this code
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name H34.8322, its category, or a range that includes it.
Excludes2 2
These codes carry an Excludes2 note naming H34.8322: 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 H34.8322 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code History & ChangesHistory
Replacement H34.8322 replaces the following previously assigned code(s):
- H34.832 - Tributary (branch) retinal vein occlusion, left eye
Questions About H34.8322Overview
What is the ICD-10 code for tributary (branch) retinal vein occlusion, left eye, stable?
The ICD-10-CM code for tributary (branch) retinal vein occlusion, left eye, stable is H34.8322 (sometimes written as H348322). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is H34.8322 (Tributary (branch) retinal vein occlusion, left eye) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report tributary (branch) retinal vein occlusion, left eye, stable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character 2 in H34.8322 mean?
The final character 2 means stable, in this case for the tributary (branch) retinal vein occlusion. It comes from the 7th character list in the CMS Tabular List for this category.
What MS-DRG does H34.8322 group to?
When tributary (branch) retinal vein occlusion, left eye, stable is the principal diagnosis on an inpatient stay, it groups to MS-DRG 123 (neurological Eye Disorders), which carries a relative weight of 0.8218. Higher weights mean higher Medicare reimbursement.
Can H34.8322 be reported with G45.3?
Not as a rule. The Excludes1 note at H34, which applies to H34.8322, 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).
What HCC is H34.8322?
H34.8322 (tributary (branch) retinal vein occlusion, left eye, stable) maps to CMS-HCC Category 298 (Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage), commonly written as HCC 298, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It does not map to any RxHCC in the Part D prescription drug model.
Does H34.8322 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, H34.8322 adds a risk adjustment factor of about 0.336 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.301 to 0.545 depending on the payment segment). HCC 298 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 298 category page.
