2026 ICD-10-CM Diagnosis Code H35.342Macular cyst, hole, or pseudohole, left eye

ICD-10-CM Codes›H00–H59›H30-H36›H35

ICD-10-CM H35.342
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

H35.342 is a billable ICD-10-CM diagnosis code for macular cyst, hole, or pseudohole, left eye. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) 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
H35.342
Billable Status
Yes — Valid for Submission
Code Describes
Macular cyst, hole, or pseudohole, left eye
Short Description
Macular cyst, hole, or pseudohole, left eye
Same as the full description in the CMS dataset.
Parent Code
H35.34
Macular cyst, hole, or pseudohole

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH30-H36Disorders of choroid and retina
CategoryH35Other retinal disorders
This CodeH35.342Macular cyst, hole, or pseudohole, left eye

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Epiretinal membrane
  • Epiretinal membrane of left eye
  • Full thickness hole of macula lutea
  • Full thickness macular hole of left eye
  • Macular cyst of left eye
  • Macular hole of left eye
  • Macular pseudohole
  • Macular pseudohole of left eye
  • Macular retinal cyst
  • Partial thickness macular hole
  • Partial thickness macular hole of left eye
  • Retinal macular break

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

  • Epiretinal Membrane

    a membrane on the vitreal surface of the retina resulting from the proliferation of one or more of three retinal elements: (1) fibrous astrocytes; (2) fibrocytes; and (3) retinal pigment epithelium. localized epiretinal membranes may occur at the posterior pole of the eye without clinical signs or may cause marked loss of vision as a result of covering, distorting, or detaching the fovea centralis. epiretinal membranes may cause vascular leakage and secondary retinal edema. in younger individuals some membranes appear to be developmental in origin and occur in otherwise normal eyes. the majority occur in association with retinal holes, ocular concussions, retinal inflammation, or after ocular surgery. (newell, ophthalmology: principles and concepts, 7th ed, p291)

Patient EducationClinical

Macular Degeneration

Macular degeneration, or age-related macular degeneration (AMD), is a leading cause of vision loss in Americans 60 and older. It is a disease that destroys your sharp, central vision. You need central vision to see objects clearly and to do tasks such as reading and driving.

Read the full article at MedlinePlus

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

Convert H35.342 to ICD-9-CMHistory

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

ICD-9-CM
362.54 Macular cyst or hole
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 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About H35.342Overview

Is H35.342 (Macular cyst, hole, or pseudohole) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report macular cyst, hole, or pseudohole, left eye on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does H35.342 group to?

When macular cyst, hole, or pseudohole, left eye is the principal diagnosis on an inpatient stay, it groups to MS-DRG 124, 125, with relative weights from 0.7678 to 1.3231 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of H35.342?

Under the General Equivalence Mappings, macular cyst, hole, or pseudohole, left eye converts to ICD-9-CM 362.54 (macular cyst or hole). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.