2027 ICD-10-CM Diagnosis Code H35.123Retinopathy of prematurity, stage 1, bilateral

ICD-10-CM Codes›H00–H59›H30-H36›H35

ICD-10-CM H35.123
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

H35.123 is a billable ICD-10-CM diagnosis code for retinopathy of prematurity, stage 1, 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. Coders also document this condition as bilateral retinopathy of prematurity. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Retinal and vitreous conditions.

Code Identity

ICD-10-CM Code
H35.123
Billable Status
Yes — Valid for Submission
Code Describes
Retinopathy of prematurity, stage 1, bilateral
Short Description
Retinopathy of prematurity, stage 1, bilateral
Same as the full description in the CMS dataset.
Parent Code
H35.12
Retinopathy of prematurity, stage 1

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH30-H36Disorders of choroid and retina
CategoryH35Other retinal disorders
This CodeH35.123Retinopathy of prematurity, stage 1, bilateral

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Bilateral retinopathy of prematurity
  • Bilateral retinopathy of prematurity of eyes stage 1 - demarcation line
  • Retinopathy of prematurity of left eye stage 1 - demarcation line
  • Retinopathy of prematurity of right eye stage 1 - demarcation line
  • Retinopathy of prematurity stage 1 - demarcation line

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to H35.123: its own notes plus those printed at H35 and Chapter 7. A note printed at a category, block or chapter applies to every code under it.

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 H35 Other retinal disorders applies to 175 codes
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.

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

Clinical InformationClinical

  • Retinopathy of Prematurity

    a bilateral retinopathy occurring in premature infants treated with excessively high concentrations of oxygen, characterized by vascular dilatation, proliferation, and tortuosity, edema, and retinal detachment, with ultimate conversion of the retina into a fibrous mass that can be seen as a dense retrolental membrane. usually growth of the eye is arrested and may result in microophthalmia, and blindness may occur. (dorland, 27th ed)

Patient EducationClinical

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.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert H35.123 to ICD-9-CMHistory

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

ICD-9-CM
362.23 Retinoph prematr,stage 1
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 H35.123Overview

What is the ICD-10 code for retinopathy of prematurity, stage 1, bilateral?

The ICD-10-CM code for retinopathy of prematurity, stage 1, bilateral is H35.123 (sometimes written as H35123). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is H35.123 (Retinopathy of prematurity, stage 1) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report retinopathy of prematurity, stage 1, bilateral on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does H35.123 group to?

When retinopathy of prematurity, stage 1, 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.

What is the ICD-9 equivalent of H35.123?

Under the General Equivalence Mappings, retinopathy of prematurity, stage 1, bilateral converts to ICD-9-CM 362.23 (retinoph prematr,stage 1). The mapping is approximate, so confirm the match fits the documentation.