Valid for Submission
H36 is a billable diagnosis code used to specify a medical diagnosis of retinal disorders in diseases classified elsewhere. The code H36 is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.
The ICD-10-CM code H36 might also be used to specify conditions or terms like carcinoma-associated retinopathy, deaf mutism, deafmutism-retinal degeneration syndrome, epstein-barr virus infection of the retina, paraneoplastic retinopathy , retinal dystrophy due to systemic disorder, etc.
Tabular List of Diseases and Injuries
The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code H36:
Code FirstCode First
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
Type 1 ExcludesType 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Carcinoma-associated retinopathy
- Deaf mutism
- Deafmutism-retinal degeneration syndrome
- Epstein-Barr virus infection of the retina
- Paraneoplastic retinopathy
- Retinal dystrophy due to systemic disorder
- Retinal dystrophy in systemic lipidosis
- Retinopathy associated with AIDS
- Sickle cell retinopathy
- Sickle cell-hemoglobin C retinopathy
Diagnostic Related Groups - MS-DRG Mapping
|MS-DRG||MS-DRG Title||MCD||Relative Weight|
|124||OTHER DISORDERS OF THE EYE WITH MCC||02||1.3988|
|125||OTHER DISORDERS OF THE EYE WITHOUT MCC||02||0.8354|
The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.
Convert H36 to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code H36 its ICD-9 equivalent. The approximate mapping means there is not an exact match between the ICD-10 code and the ICD-9 code and the mapped code is not a precise representation of the original code.
Information for Patients
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
- Macular degeneration - a disease that destroys your sharp, central vision
- Diabetic eye disease
- Retinal detachment - a medical emergency, when the retina is pulled away from the back of the eye
- Retinoblastoma - cancer of the retina. It is most common in young children.
- Macular pucker - scar tissue on the macula
- Macular hole - a small break in the macula that usually happens to people over 60
- Floaters - cobwebs or specks in your field of vision
NIH: National Eye Institute
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