2022 ICD-10-CM Code H35.1

Retinopathy of prematurity

Version 2021

Not Valid for Submission

ICD-10:H35.1
Short Description:Retinopathy of prematurity
Long Description:Retinopathy of prematurity

Code Classification

  • Diseases of the eye and adnexa (H00–H59)
    • Disorders of choroid and retina (H30-H36)
      • Other retinal disorders (H35)

H35.1 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of retinopathy of prematurity. The code is not specific and is NOT valid for the year 2022 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

Specific Coding for Retinopathy of prematurity

Non-specific codes like H35.1 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10 codes with a higher level of specificity when coding for retinopathy of prematurity:

  • NON-BILLABLE CODE - H35.10 for Retinopathy of prematurity, unspecified
  • BILLABLE CODE - Use H35.101 for Retinopathy of prematurity, unspecified, right eye
  • BILLABLE CODE - Use H35.102 for Retinopathy of prematurity, unspecified, left eye
  • BILLABLE CODE - Use H35.103 for Retinopathy of prematurity, unspecified, bilateral
  • BILLABLE CODE - Use H35.109 for Retinopathy of prematurity, unspecified, unspecified eye
  • NON-BILLABLE CODE - H35.11 for Retinopathy of prematurity, stage 0
  • BILLABLE CODE - Use H35.111 for Retinopathy of prematurity, stage 0, right eye
  • BILLABLE CODE - Use H35.112 for Retinopathy of prematurity, stage 0, left eye
  • BILLABLE CODE - Use H35.113 for Retinopathy of prematurity, stage 0, bilateral
  • BILLABLE CODE - Use H35.119 for Retinopathy of prematurity, stage 0, unspecified eye
  • NON-BILLABLE CODE - H35.12 for Retinopathy of prematurity, stage 1
  • BILLABLE CODE - Use H35.121 for Retinopathy of prematurity, stage 1, right eye
  • BILLABLE CODE - Use H35.122 for Retinopathy of prematurity, stage 1, left eye
  • BILLABLE CODE - Use H35.123 for Retinopathy of prematurity, stage 1, bilateral
  • BILLABLE CODE - Use H35.129 for Retinopathy of prematurity, stage 1, unspecified eye
  • NON-BILLABLE CODE - H35.13 for Retinopathy of prematurity, stage 2
  • BILLABLE CODE - Use H35.131 for Retinopathy of prematurity, stage 2, right eye
  • BILLABLE CODE - Use H35.132 for Retinopathy of prematurity, stage 2, left eye
  • BILLABLE CODE - Use H35.133 for Retinopathy of prematurity, stage 2, bilateral
  • BILLABLE CODE - Use H35.139 for Retinopathy of prematurity, stage 2, unspecified eye
  • NON-BILLABLE CODE - H35.14 for Retinopathy of prematurity, stage 3
  • BILLABLE CODE - Use H35.141 for Retinopathy of prematurity, stage 3, right eye
  • BILLABLE CODE - Use H35.142 for Retinopathy of prematurity, stage 3, left eye
  • BILLABLE CODE - Use H35.143 for Retinopathy of prematurity, stage 3, bilateral
  • BILLABLE CODE - Use H35.149 for Retinopathy of prematurity, stage 3, unspecified eye
  • NON-BILLABLE CODE - H35.15 for Retinopathy of prematurity, stage 4
  • BILLABLE CODE - Use H35.151 for Retinopathy of prematurity, stage 4, right eye
  • BILLABLE CODE - Use H35.152 for Retinopathy of prematurity, stage 4, left eye
  • BILLABLE CODE - Use H35.153 for Retinopathy of prematurity, stage 4, bilateral
  • BILLABLE CODE - Use H35.159 for Retinopathy of prematurity, stage 4, unspecified eye
  • NON-BILLABLE CODE - H35.16 for Retinopathy of prematurity, stage 5
  • BILLABLE CODE - Use H35.161 for Retinopathy of prematurity, stage 5, right eye
  • BILLABLE CODE - Use H35.162 for Retinopathy of prematurity, stage 5, left eye
  • BILLABLE CODE - Use H35.163 for Retinopathy of prematurity, stage 5, bilateral
  • BILLABLE CODE - Use H35.169 for Retinopathy of prematurity, stage 5, unspecified eye
  • NON-BILLABLE CODE - H35.17 for Retrolental fibroplasia
  • BILLABLE CODE - Use H35.171 for Retrolental fibroplasia, right eye
  • BILLABLE CODE - Use H35.172 for Retrolental fibroplasia, left eye
  • BILLABLE CODE - Use H35.173 for Retrolental fibroplasia, bilateral
  • BILLABLE CODE - Use H35.179 for Retrolental fibroplasia, unspecified eye

Clinical Information

Information for Patients


Premature Babies

Almost 1 of every 10 infants born in the United States are premature, or preemies. A premature birth is when a baby is born before 37 completed weeks of pregnancy. A full-term pregnancy is 40 weeks.

Important growth and development happen throughout pregnancy - especially in the final months and weeks. Because they are born too early, preemies weigh much less than full-term babies. They may have health problems because their organs did not have enough time to develop. Problems that a baby born too early may have include

Preemies need special medical care in a neonatal intensive care unit, or NICU. They stay there until their organ systems can work on their own.

Centers for Disease Control and Prevention


[Learn More in MedlinePlus]

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.

Retinal disorders affect this vital tissue. They can affect your vision, and some can be serious enough to cause blindness. Examples are

NIH: National Eye Institute


[Learn More in MedlinePlus]

Code History

  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)