2026 ICD-10-CM Diagnosis Code H36.829Proliferative sickle-cell retinopathy, unspecified eye

ICD-10-CM Codes›H00–H59›H30-H36›H36

ICD-10-CM H36.829
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

H36.829 is a billable ICD-10-CM diagnosis code for proliferative sickle-cell retinopathy, unspecified 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. The code is not accepted as a principal diagnosis by the Medicare Code Editor. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Retinal and vitreous conditions and Sickle cell trait/anemia.

Code Identity

ICD-10-CM Code
H36.829
Billable Status
Yes — Valid for Submission
Code Describes
Proliferative sickle-cell retinopathy, unspecified eye
Short Description
Proliferative sickle-cell retinopathy, unspecified eye
Same as the full description in the CMS dataset.
Parent Code
H36.82
Proliferative sickle-cell retinopathy

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH30-H36Disorders of choroid and retina
CategoryH36Retinal disorders in diseases classified elsewhere
This CodeH36.829Proliferative sickle-cell retinopathy, unspecified eye

Code EditsBilling

Medicare Code Editor checks that affect claim validity for H36.829.

Unacceptable principal diagnosis
There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR EYE005
Retinal and vitreous conditions
Default principal diagnosis: inpatient No · outpatient No
CCSR BLD005
Sickle cell trait/anemia
Default principal diagnosis: inpatient No · outpatient Yes

Code History & ChangesHistory

Replacement H36.829 replaces the following previously assigned code(s):

  • H35.20 - Other non-diabetic proliferative retinopathy, unsp eye
  • H35.23 - Other non-diabetic proliferative retinopathy, bilateral
FY 2024AddedAdded to the ICD-10-CM code setEffective October 1, 2023.
FY 2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About H36.829Overview

Is H36.829 (Proliferative sickle-cell retinopathy) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report proliferative sickle-cell retinopathy, unspecified eye on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does H36.829 group to?

On inpatient claims, proliferative sickle-cell retinopathy, unspecified eye maps to MS-DRG 124, 125, with relative weights from 0.7678 to 1.3231 depending on complications. Higher weights mean higher Medicare reimbursement.

Can H36.829 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because proliferative sickle-cell retinopathy, unspecified eye describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

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.