2027 ICD-10-CM Diagnosis Code H35.81Retinal edema

ICD-10-CM Codes›H00–H59›H30-H36›H35

ICD-10-CM H35.81
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

H35.81 is a billable ICD-10-CM diagnosis code for retinal edema. 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. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Retinal and vitreous conditions.

Code Identity

ICD-10-CM Code
H35.81
Billable Status
Yes — Valid for Submission
Code Describes
Retinal edema
Short Description
Retinal edema
Same as the full description in the CMS dataset.
Parent Code
H35.8
Other specified retinal disorders

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH30-H36Disorders of choroid and retina
CategoryH35Other retinal disorders
This CodeH35.81Retinal edema

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Autosomal dominant cystoid macular edema
  • Bilateral cystoid macular edema of retinas
  • Clinically significant macular edema
  • Cotton wool spots
  • Cotton wool spots of left eye
  • Cotton wool spots of right eye
  • Cystoid macular edema
  • Cystoid macular edema of left retina
  • Cystoid macular edema of right retina
  • Localized edema
  • Localized retinal edema
  • Macular edema of retina of bilateral eyes
  • Macular edema of retina of left eye
  • Macular edema of retina of right eye
  • Macular retinal edema
  • Noncystoid edema of macula of retina
  • Peripheral retinal edema
  • Retinal deposits of left eye
  • Retinal deposits of right eye
  • Retinal edema
  • Uveitis related cystoid macular edema
  • Widespread retinal edema

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to H35.81: its own notes plus those printed at H35.8, H35, and Chapter 7. A note printed at a category, block or chapter applies to every code under it.

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

  • Retinal cotton wool spots

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 H35.8 Other specified retinal disorders applies to 3 codes
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.

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

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

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 H35.81 to ICD-9-CMHistory

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

ICD-9-CM
362.83 Retinal edema
Exact Match The mapping is direct, with no qualifiers.

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 H35.81Overview

What is the ICD-10 code for retinal edema?

The ICD-10-CM code for retinal edema is H35.81 (sometimes written as H3581). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is H35.81 (Other specified retinal disorders) a billable code?

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

What MS-DRG does H35.81 group to?

When retinal edema 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 H35.81?

Under the General Equivalence Mappings, retinal edema converts to ICD-9-CM 362.83 (retinal edema). The mapping is a direct match.