2026 ICD-10-CM Diagnosis Code H36.89Other retinal disorders in diseases classified elsewhere

ICD-10-CM Codes›H00–H59›H30-H36›H36

ICD-10-CM H36.89
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

H36.89 is a billable ICD-10-CM diagnosis code for other retinal disorders in diseases classified elsewhere. 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 a manifestation code that cannot be reported as the principal diagnosis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Retinal and vitreous conditions.

Code Identity

ICD-10-CM Code
H36.89
Billable Status
Yes — Valid for Submission
Code Describes
Other retinal disorders in diseases classified elsewhere
Short Description
Other retinal disorders in diseases classified elsewhere
Same as the full description in the CMS dataset.
Parent Code
H36.8
Other retinal disorders in diseases classified elsewhere

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH30-H36Disorders of choroid and retina
CategoryH36Retinal disorders in diseases classified elsewhere
This CodeH36.89Other retinal disorders in diseases classified elsewhere

Code EditsBilling

Medicare Code Editor checks that affect claim validity for H36.89.

Manifestation diagnoses
Manifestation codes describe the manifestation of an underlying disease, not the disease itself, and therefore should not be used as a principal diagnosis.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Carcinoma-associated retinopathy
  • Deaf mutism
  • Deafmutism-retinal degeneration syndrome
  • Disorder of eye proper co-occurrent with human immunodeficiency virus infection
  • Epstein-Barr virus infection of the retina
  • Paraneoplastic retinopathy
  • Retinal dystrophy due to GM2 gangliosidosis
  • Retinal dystrophy due to systemic disorder
  • Retinal dystrophy in systemic lipidosis
  • Retinopathy due to sickle cell trait
  • Retinopathy with AIDS
  • Sickle cell retinopathy
  • Sickle cell-hemoglobin C retinopathy

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Inclusion Terms

  • Retinal dystrophy in lipid storage disorders

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

Code History & ChangesHistory

Replacement H36.89 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 H36.89Overview

Is H36.89 (Other retinal disorders in diseases classified elsewhere) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report other retinal disorders in diseases classified elsewhere on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does H36.89 group to?

On inpatient claims, other retinal disorders in diseases classified elsewhere 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 H36.89 be a principal diagnosis?

No. This is a manifestation code: other retinal disorders in diseases classified elsewhere describes the manifestation of an underlying disease rather than the disease itself, so the underlying condition is sequenced first.

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.