2027 ICD-10-CM Diagnosis Code H36.89Other retinal disorders in diseases classified elsewhere
ICD-10-CM Codes›H00–H59›H30-H36›H36
- Billable — Valid for Submission
- Chronic Condition
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 2027 (October 1, 2026 through September 30, 2027) 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
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for H36.89.
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
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to H36.89: its own notes plus those printed at H36 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 dystrophy in lipid storage disorders
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
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.
- 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)
Code First
The underlying condition named in the note is sequenced before this code.
Notes
General instructions on how these codes are used.
- 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.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
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.
Code History & ChangesHistory
Replacement H36.89 replaces the following previously assigned code(s):
- H35.20 - Other non-diabetic proliferative retinopathy, unsp eye
- H35.21 - Other non-diabetic proliferative retinopathy, right eye
- H35.22 - Other non-diabetic proliferative retinopathy, left eye
- H35.23 - Other non-diabetic proliferative retinopathy, bilateral
Questions About H36.89Overview
What is the ICD-10 code for other retinal disorders in diseases classified elsewhere?
The ICD-10-CM code for other retinal disorders in diseases classified elsewhere is H36.89 (sometimes written as H3689). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
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, 2026 through September 30, 2027.
What MS-DRG does H36.89 group to?
On inpatient claims, other retinal disorders in diseases classified elsewhere maps to MS-DRG 125, 124, with relative weights from 0.7699 to 1.2470 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.
Can H36.89 be reported with a code from H35.0?
Not as a rule. The Excludes1 note at H36, which applies to H36.89, lists "arteriosclerotic retinopathy (H35.0-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
