Version 2024

2024 ICD-10-CM Diagnosis Code H44.2B9

Degenerative myopia with macular hole, unspecified eye

ICD-10-CM Code:: H44.2B9
ICD-10 Code for:: Degenerative myopia with macular hole, unspecified eye
Is Billable?: Yes - Valid for Submission
Chronic Condition Indicator: ^[1]: Chronic
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Code Information
Approximate Synonyms
Clinical Classification
Tabular List of Diseases and Injuries
Diagnostic Related Groups Mapping
Replacement Code
Convert to ICD-9 Code
Patient Education
Other Codes Used Similar Conditions
Code History

Code Classification

Diseases of the eye and adnexa
(H00–H59)
- Disorders of vitreous body and globe
  (H43-H44)
  - Disorders of globe
    (H44)

H44.2B9 is a billable diagnosis code used to specify a medical diagnosis of degenerative myopia with macular hole, unspecified eye. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

Unspecified diagnosis codes like H44.2B9 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

Macular hole due to degenerative high myopia

Clinical Classification

Clinical Category is Other specified eye disorders
CCSR Category Code: EYE012
Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

H44.2B9 is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
124	OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT	02	1.3219
125	OTHER DISORDERS OF THE EYE WITHOUT MCC	02	0.7975

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.

Replacement Code

H442B9 replaces the following previously assigned ICD-10-CM code(s):

H35.30 - Unspecified macular degeneration
H44.20 - Degenerative myopia, unspecified eye
H44.21 - Degenerative myopia, right eye
H44.22 - Degenerative myopia, left eye
H44.23 - Degenerative myopia, bilateral

Convert H44.2B9 to ICD-9-CM

ICD-9-CM Code: 360.21 - Progressive high myopia
Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.
ICD-9-CM Code: 362.54 - Macular cyst or hole
Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.

Other ICD-10-CM Codes Commonly Used for Similar Conditions

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Code History

FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018

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.