2024 ICD-10-CM Diagnosis Code H35.30

Approximate Synonyms

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

• Advanced age related macular degeneration
• Age related macular degeneration
• Atrophy of macula lutea
• Atrophy of macula lutea
• Bilateral congenital anomaly of optic disc
• Bilateral congenital anomaly of retinas
• Bilateral congenital coloboma of optic discs
• Bilateral degeneration of macula
• Bilateral degenerative progressive high myopia of eyes
• Bilateral myopia of eyes
• Bull's eye maculopathy
• Colobomatous optic disc, macular atrophy, chorioretinopathy syndrome
• Congenital anomaly of left optic disc
• Congenital anomaly of right optic disc
• Congenital coloboma of left optic disc
• Congenital coloboma of optic disc
• Congenital coloboma of right optic disc
• Degeneration of posterior pole of eye
• Degenerative disorder of macula
• Degenerative disorder of macula of left eye
• Degenerative disorder of macula of left eye
• Degenerative disorder of macula of right eye
• Degenerative disorder of macula of right eye
• Degenerative myopia of left eye
• Degenerative myopia of left eye
• Degenerative myopia of right eye
• Degenerative myopia of right eye
• Degenerative progressive high myopia
• Degenerative progressive high myopia
• Degenerative progressive high myopia
• Degenerative progressive high myopia of left eye
• Degenerative progressive high myopia of left eye
• Degenerative progressive high myopia of right eye
• Degenerative progressive high myopia of right eye
• Early age related macular degeneration
• Intermediate age related macular degeneration
• Macular diffuse atrophy
• Myopia of left eye
• Myopia of left eye
• Myopia of right eye
• Myopia of right eye
• Myopic macular degeneration
• Myopic macular degeneration
• Myopic macular degeneration
• Myopic macular degeneration of bilateral eyes
• Myopic macular degeneration of left eye
• Myopic macular degeneration of left eye
• Myopic macular degeneration of right eye
• Myopic macular degeneration of right eye
• Persistent placoid maculopathy
• Post-radiation maculopathy
• Radiation retinopathy

Clinical Information

• Geographic Atrophy

  a form of macular degeneration also known as dry macular degeneration marked by occurrence of a well-defined progressive lesion or atrophy in the central part of the retina called the macula lutea. it is distinguishable from wet macular degeneration in that the latter involves neovascular exudates.

• Macular Degeneration

  degenerative changes in the retina usually of older adults which results in a loss of vision in the center of the visual field (the macula lutea) because of damage to the retina. it occurs in dry and wet forms.

• Stargardt Disease

  a juvenile-onset macular dystrophy characterized by progressive loss of visual acuity with normal acuity in peripheral visual fields. other associated clinical features may include lipofuscin fundus autofluorescence, atrophy of the retinal pigment epithelium, loss of color vision, photophobia and paracentral scotoma. germline mutations in the abca4 gene have been identified in recessive and dominant diseases.

• Vitelliform Macular Dystrophy

  autosomal dominant hereditary maculopathy with childhood-onset accumulation of lipofusion in retinal pigment epithelium. affected individuals develop progressive central acuity loss, and distorted vision (metamorphopsia). it is associated with mutations in bestrophin, a chloride channel.

• Wet Macular Degeneration

  a form of retinal degeneration in which abnormal choroidal neovascularization occurs under the retina and macula lutea, causing bleeding and leaking of fluid. this leads to bulging and or lifting of the macula and the distortion or destruction of central vision.

• Radiation Retinopathy

  injury of the retina following exposure to radiation. the retinal injury results from occlusive microangiopathy caused by endothelial cell loss.

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

• Adult diagnoses - The Medicare Code Editor detects inconsistencies in adult cases by checking a patient's age and any diagnosis on the patient's record. The adult code edits apply to patients age range is 15–124 years inclusive (e.g., senile delirium, mature cataract).

H35.30 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.

Convert H35.30 to ICD-9-CM

• ICD-9-CM Code: 362.50 - Macular degeneration NOS

Patient Education

Macular Degeneration

Macular degeneration, or age-related macular degeneration (AMD), is a leading cause of vision loss in Americans 60 and older. It is a disease that destroys your sharp, central vision. You need central vision to see objects clearly and to do tasks such as reading and driving.

AMD affects the macula, the part of the eye that allows you to see fine detail. It does not hurt, but it causes cells in the macula to die. There are two types: wet and dry. Wet AMD happens when abnormal blood vessels grow under the macula. These new blood vessels often leak blood and fluid. Wet AMD damages the macula quickly. Blurred vision is a common early symptom. Dry AMD happens when the light-sensitive cells in the macula slowly break down. Your gradually lose your central vision. A common early symptom is that straight lines appear crooked.

Regular comprehensive eye exams can detect macular degeneration before the disease causes vision loss. Treatment can slow vision loss. It does not restore vision.

NIH: National Eye Institute

[Learn More in MedlinePlus]

Age-related macular degeneration

Age-related macular degeneration is an eye disease that is a leading cause of vision loss in older people in developed countries. Subtle abnormalities indicating changes in vision may occur in a person's forties or fifties. Distorted vision and vision loss usually become noticeable in a person's sixties or seventies and tend to worsen over time.

Age-related macular degeneration mainly affects central vision, which is needed for detailed tasks such as reading, driving, and recognizing faces. The vision loss in this condition results from a gradual deterioration of light-sensing cells in the tissue at the back of the eye that detects light and color (the retina). Specifically, age-related macular degeneration affects a small area near the center of the retina, called the macula, which is responsible for central vision. Side (peripheral) vision and night vision are generally not affected, but slow adjustment of vision to darkness (dark adaptation) and reduced dim light (scotopic) vision often occur in the early stages of the disease.

Researchers have described two major types of age-related macular degeneration, known as the dry form and the wet form. The dry form is much more common, accounting for 85 to 90 percent of all cases of age-related macular degeneration. It is characterized by a buildup of yellowish deposits called drusen beneath the retina and vision loss that worsens slowly over time. The most advanced stage of dry age-related macular degeneration is known as geographic atrophy, in which areas of the macula waste away (atrophy), resulting in severe vision loss. Dry age-related macular degeneration typically affects vision in both eyes, although vision loss often occurs in one eye before the other.

In 10 to 15 percent of affected individuals, the dry form progresses to the wet form of age-related macular degeneration. The wet form is characterized by the growth of abnormal, fragile blood vessels underneath the macula. These vessels leak blood and fluid, which damages the macula and makes central vision appear blurry and distorted. The wet form of age-related macular degeneration is associated with severe vision loss that can worsen rapidly.

[Learn More in MedlinePlus]

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
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.