SUPERSEDED LCD Reference Article Billing and Coding Article

Billing and Coding: Electroretinography (ERG)

A56672

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Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.
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Source Article ID
N/A
Article ID
A56672
Original ICD-9 Article ID
Not Applicable
Article Title
Billing and Coding: Electroretinography (ERG)
Article Type
Billing and Coding
Original Effective Date
07/11/2019
Revision Effective Date
11/21/2019
Revision Ending Date
09/30/2023
Retirement Date
N/A
AMA CPT / ADA CDT / AHA NUBC Copyright Statement

CPT codes, descriptions and other data only are copyright 2023 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

Current Dental Terminology © 2023 American Dental Association. All rights reserved.

Copyright © 2023, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB‐04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of the AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312‐893‐6816.

Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. The views and/or positions presented in the material do not necessarily represent the views of the AHA. CMS and its products and services are not endorsed by the AHA or any of its affiliates.

CMS National Coverage Policy

N/A

Article Guidance

Article Text

Refer to the Novitas Local Coverage Determination (LCD) L37371, Electroretinography (ERG), for reasonable and necessary requirements.

The Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) code(s) may be subject to National Correct Coding Initiative (NCCI) edits. This information does not take precedence over NCCI edits. Please refer to NCCI for correct coding guidelines and specific applicable code combinations prior to billing Medicare.



Coding Information

When reporting ICD-10 code Z79.899, the medical record must reflect the medication administered as well as the underlying condition for which it was given.

Response To Comments

Number Comment Response
1
N/A

Coding Information

Bill Type Codes

Code Description
999x Not Applicable
N/A

Revenue Codes

Code Description
99999 Not Applicable
N/A

CPT/HCPCS Codes

Group 1

(3 Codes)
Group 1 Paragraph

Note: Providers are reminded to refer to the long descriptors of the CPT codes in their CPT book.

Group 1 Codes
Code Description
92273 Full field erg w/i&r
92274 Multifocal erg w/i&r
0509T Pattern erg w/i&r
N/A

CPT/HCPCS Modifiers

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

ICD-10-CM Codes that Support Medical Necessity

Group 1

(647 Codes)
Group 1 Paragraph

It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim(s) submitted.

Medicare is establishing the following limited coverage for CPT codes 92273, 92274, and 0509T:

Note:

  • ICD-10 code D18.09 is to be reported for “retinal” hemangioma.
  • ICD-10 code Z79.899 is to be reported for patients receiving vigabatrin, chlorpromazine, chloroquine or hydroxychloroquine being evaluated for retinal toxicity.
Group 1 Codes
Code Description
A18.53 Tuberculous chorioretinitis
D18.09 Hemangioma of other sites
E08.311 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema
E08.319 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy without macular edema
E08.3211 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, right eye
E08.3212 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, left eye
E08.3213 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E08.3291 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, right eye
E08.3292 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, left eye
E08.3293 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E08.3311 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, right eye
E08.3312 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, left eye
E08.3313 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E08.3391 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, right eye
E08.3392 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, left eye
E08.3393 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E08.3411 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, right eye
E08.3412 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, left eye
E08.3413 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E08.3491 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, right eye
E08.3492 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, left eye
E08.3493 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E08.3511 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, right eye
E08.3512 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, left eye
E08.3513 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, bilateral
E08.3521 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
E08.3522 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
E08.3523 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E08.3531 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
E08.3532 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
E08.3533 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E08.3541 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
E08.3542 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
E08.3543 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E08.3551 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, right eye
E08.3552 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, left eye
E08.3553 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, bilateral
E08.3591 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, right eye
E08.3592 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, left eye
E08.3593 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, bilateral
E09.311 Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy with macular edema
E09.319 Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy without macular edema
E09.3211 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
E09.3212 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
E09.3213 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E09.3291 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
E09.3292 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
E09.3293 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E09.3311 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
E09.3312 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
E09.3313 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E09.3391 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
E09.3392 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
E09.3393 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E09.3411 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
E09.3412 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
E09.3413 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E09.3491 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
E09.3492 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
E09.3493 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E09.3511 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
E09.3512 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
E09.3513 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
E09.3521 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
E09.3522 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
E09.3523 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E09.3531 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
E09.3532 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
E09.3533 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E09.3541 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
E09.3542 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
E09.3543 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E09.3551 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, right eye
E09.3552 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, left eye
E09.3553 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
E09.3591 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
E09.3592 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
E09.3593 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
E10.311 Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema
E10.319 Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema
E10.3211 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
E10.3212 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
E10.3213 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E10.3291 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
E10.3292 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
E10.3293 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E10.3311 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
E10.3312 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
E10.3313 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E10.3391 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
E10.3392 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
E10.3393 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E10.3411 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
E10.3412 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
E10.3413 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E10.3491 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
E10.3492 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
E10.3493 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E10.3511 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
E10.3512 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
E10.3513 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
E10.3521 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
E10.3522 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
E10.3523 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E10.3531 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
E10.3532 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
E10.3533 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E10.3541 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
E10.3542 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
E10.3543 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E10.3551 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, right eye
E10.3552 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, left eye
E10.3553 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
E10.3591 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
E10.3592 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
E10.3593 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
E11.311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema
E11.319 Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema
E11.3211 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
E11.3212 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
E11.3213 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E11.3291 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
E11.3292 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
E11.3293 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E11.3311 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
E11.3312 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
E11.3313 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E11.3391 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
E11.3392 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
E11.3393 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E11.3411 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
E11.3412 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
E11.3413 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E11.3491 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
E11.3492 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
E11.3493 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E11.3511 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
E11.3512 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
E11.3513 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
E11.3521 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
E11.3522 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
E11.3523 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E11.3531 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
E11.3532 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
E11.3533 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E11.3541 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
E11.3542 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
E11.3543 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E11.3551 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, right eye
E11.3552 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left eye
E11.3553 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
E11.3591 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
E11.3592 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
E11.3593 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
E13.311 Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema
E13.319 Other specified diabetes mellitus with unspecified diabetic retinopathy without macular edema
E13.3211 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
E13.3212 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
E13.3213 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E13.3291 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
E13.3292 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
E13.3293 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E13.3311 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
E13.3312 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
E13.3313 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E13.3391 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
E13.3392 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
E13.3393 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E13.3411 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
E13.3412 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
E13.3413 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E13.3491 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
E13.3492 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
E13.3493 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E13.3511 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
E13.3512 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
E13.3513 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
E13.3521 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
E13.3522 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
E13.3523 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E13.3531 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
E13.3532 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
E13.3533 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E13.3541 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
E13.3542 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
E13.3543 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E13.3551 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, right eye
E13.3552 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, left eye
E13.3553 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
E13.3591 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
E13.3592 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
E13.3593 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
E50.5 Vitamin A deficiency with night blindness
E50.9 Vitamin A deficiency, unspecified
F44.6 Conversion disorder with sensory symptom or deficit
G45.3 Amaurosis fugax
H15.031 Posterior scleritis, right eye
H15.032 Posterior scleritis, left eye
H15.033 Posterior scleritis, bilateral
H20.011 Primary iridocyclitis, right eye
H20.012 Primary iridocyclitis, left eye
H20.013 Primary iridocyclitis, bilateral
H30.001 Unspecified focal chorioretinal inflammation, right eye
H30.002 Unspecified focal chorioretinal inflammation, left eye
H30.003 Unspecified focal chorioretinal inflammation, bilateral
H30.011 Focal chorioretinal inflammation, juxtapapillary, right eye
H30.012 Focal chorioretinal inflammation, juxtapapillary, left eye
H30.013 Focal chorioretinal inflammation, juxtapapillary, bilateral
H30.021 Focal chorioretinal inflammation of posterior pole, right eye
H30.022 Focal chorioretinal inflammation of posterior pole, left eye
H30.023 Focal chorioretinal inflammation of posterior pole, bilateral
H30.031 Focal chorioretinal inflammation, peripheral, right eye
H30.032 Focal chorioretinal inflammation, peripheral, left eye
H30.033 Focal chorioretinal inflammation, peripheral, bilateral
H30.041 Focal chorioretinal inflammation, macular or paramacular, right eye
H30.042 Focal chorioretinal inflammation, macular or paramacular, left eye
H30.043 Focal chorioretinal inflammation, macular or paramacular, bilateral
H30.101 Unspecified disseminated chorioretinal inflammation, right eye
H30.102 Unspecified disseminated chorioretinal inflammation, left eye
H30.103 Unspecified disseminated chorioretinal inflammation, bilateral
H30.111 Disseminated chorioretinal inflammation of posterior pole, right eye
H30.112 Disseminated chorioretinal inflammation of posterior pole, left eye
H30.113 Disseminated chorioretinal inflammation of posterior pole, bilateral
H30.121 Disseminated chorioretinal inflammation, peripheral right eye
H30.122 Disseminated chorioretinal inflammation, peripheral, left eye
H30.123 Disseminated chorioretinal inflammation, peripheral, bilateral
H30.131 Disseminated chorioretinal inflammation, generalized, right eye
H30.132 Disseminated chorioretinal inflammation, generalized, left eye
H30.133 Disseminated chorioretinal inflammation, generalized, bilateral
H30.141 Acute posterior multifocal placoid pigment epitheliopathy, right eye
H30.142 Acute posterior multifocal placoid pigment epitheliopathy, left eye
H30.143 Acute posterior multifocal placoid pigment epitheliopathy, bilateral
H30.21 Posterior cyclitis, right eye
H30.22 Posterior cyclitis, left eye
H30.23 Posterior cyclitis, bilateral
H30.811 Harada's disease, right eye
H30.812 Harada's disease, left eye
H30.813 Harada's disease, bilateral
H30.891 Other chorioretinal inflammations, right eye
H30.892 Other chorioretinal inflammations, left eye
H30.893 Other chorioretinal inflammations, bilateral
H30.91 Unspecified chorioretinal inflammation, right eye
H30.92 Unspecified chorioretinal inflammation, left eye
H30.93 Unspecified chorioretinal inflammation, bilateral
H31.001 Unspecified chorioretinal scars, right eye
H31.002 Unspecified chorioretinal scars, left eye
H31.003 Unspecified chorioretinal scars, bilateral
H31.011 Macula scars of posterior pole (postinflammatory) (post-traumatic), right eye
H31.012 Macula scars of posterior pole (postinflammatory) (post-traumatic), left eye
H31.013 Macula scars of posterior pole (postinflammatory) (post-traumatic), bilateral
H31.021 Solar retinopathy, right eye
H31.022 Solar retinopathy, left eye
H31.023 Solar retinopathy, bilateral
H31.091 Other chorioretinal scars, right eye
H31.092 Other chorioretinal scars, left eye
H31.093 Other chorioretinal scars, bilateral
H31.101 Choroidal degeneration, unspecified, right eye
H31.102 Choroidal degeneration, unspecified, left eye
H31.103 Choroidal degeneration, unspecified, bilateral
H31.111 Age-related choroidal atrophy, right eye
H31.112 Age-related choroidal atrophy, left eye
H31.113 Age-related choroidal atrophy, bilateral
H31.121 Diffuse secondary atrophy of choroid, right eye
H31.122 Diffuse secondary atrophy of choroid, left eye
H31.123 Diffuse secondary atrophy of choroid, bilateral
H31.20 Hereditary choroidal dystrophy, unspecified
H31.21 Choroideremia
H31.22 Choroidal dystrophy (central areolar) (generalized) (peripapillary)
H31.23 Gyrate atrophy, choroid
H31.29 Other hereditary choroidal dystrophy
H31.301 Unspecified choroidal hemorrhage, right eye
H31.302 Unspecified choroidal hemorrhage, left eye
H31.303 Unspecified choroidal hemorrhage, bilateral
H31.311 Expulsive choroidal hemorrhage, right eye
H31.312 Expulsive choroidal hemorrhage, left eye
H31.313 Expulsive choroidal hemorrhage, bilateral
H31.321 Choroidal rupture, right eye
H31.322 Choroidal rupture, left eye
H31.323 Choroidal rupture, bilateral
H31.401 Unspecified choroidal detachment, right eye
H31.402 Unspecified choroidal detachment, left eye
H31.403 Unspecified choroidal detachment, bilateral
H31.411 Hemorrhagic choroidal detachment, right eye
H31.412 Hemorrhagic choroidal detachment, left eye
H31.413 Hemorrhagic choroidal detachment, bilateral
H31.421 Serous choroidal detachment, right eye
H31.422 Serous choroidal detachment, left eye
H31.423 Serous choroidal detachment, bilateral
H33.001 Unspecified retinal detachment with retinal break, right eye
H33.002 Unspecified retinal detachment with retinal break, left eye
H33.003 Unspecified retinal detachment with retinal break, bilateral
H33.011 Retinal detachment with single break, right eye
H33.012 Retinal detachment with single break, left eye
H33.013 Retinal detachment with single break, bilateral
H33.021 Retinal detachment with multiple breaks, right eye
H33.022 Retinal detachment with multiple breaks, left eye
H33.023 Retinal detachment with multiple breaks, bilateral
H33.031 Retinal detachment with giant retinal tear, right eye
H33.032 Retinal detachment with giant retinal tear, left eye
H33.033 Retinal detachment with giant retinal tear, bilateral
H33.041 Retinal detachment with retinal dialysis, right eye
H33.042 Retinal detachment with retinal dialysis, left eye
H33.043 Retinal detachment with retinal dialysis, bilateral
H33.051 Total retinal detachment, right eye
H33.052 Total retinal detachment, left eye
H33.053 Total retinal detachment, bilateral
H33.101 Unspecified retinoschisis, right eye
H33.102 Unspecified retinoschisis, left eye
H33.103 Unspecified retinoschisis, bilateral
H33.111 Cyst of ora serrata, right eye
H33.112 Cyst of ora serrata, left eye
H33.113 Cyst of ora serrata, bilateral
H33.191 Other retinoschisis and retinal cysts, right eye
H33.192 Other retinoschisis and retinal cysts, left eye
H33.193 Other retinoschisis and retinal cysts, bilateral
H33.21 Serous retinal detachment, right eye
H33.22 Serous retinal detachment, left eye
H33.23 Serous retinal detachment, bilateral
H33.301 Unspecified retinal break, right eye
H33.302 Unspecified retinal break, left eye
H33.303 Unspecified retinal break, bilateral
H33.311 Horseshoe tear of retina without detachment, right eye
H33.312 Horseshoe tear of retina without detachment, left eye
H33.313 Horseshoe tear of retina without detachment, bilateral
H33.321 Round hole, right eye
H33.322 Round hole, left eye
H33.323 Round hole, bilateral
H33.331 Multiple defects of retina without detachment, right eye
H33.332 Multiple defects of retina without detachment, left eye
H33.333 Multiple defects of retina without detachment, bilateral
H33.41 Traction detachment of retina, right eye
H33.42 Traction detachment of retina, left eye
H33.43 Traction detachment of retina, bilateral
H33.8 Other retinal detachments
H34.01 Transient retinal artery occlusion, right eye
H34.02 Transient retinal artery occlusion, left eye
H34.03 Transient retinal artery occlusion, bilateral
H34.11 Central retinal artery occlusion, right eye
H34.12 Central retinal artery occlusion, left eye
H34.13 Central retinal artery occlusion, bilateral
H34.211 Partial retinal artery occlusion, right eye
H34.212 Partial retinal artery occlusion, left eye
H34.213 Partial retinal artery occlusion, bilateral
H34.231 Retinal artery branch occlusion, right eye
H34.232 Retinal artery branch occlusion, left eye
H34.233 Retinal artery branch occlusion, bilateral
H34.8110 Central retinal vein occlusion, right eye, with macular edema
H34.8111 Central retinal vein occlusion, right eye, with retinal neovascularization
H34.8112 Central retinal vein occlusion, right eye, stable
H34.8120 Central retinal vein occlusion, left eye, with macular edema
H34.8121 Central retinal vein occlusion, left eye, with retinal neovascularization
H34.8122 Central retinal vein occlusion, left eye, stable
H34.8130 Central retinal vein occlusion, bilateral, with macular edema
H34.8131 Central retinal vein occlusion, bilateral, with retinal neovascularization
H34.8132 Central retinal vein occlusion, bilateral, stable
H34.821 Venous engorgement, right eye
H34.822 Venous engorgement, left eye
H34.823 Venous engorgement, bilateral
H34.8310 Tributary (branch) retinal vein occlusion, right eye, with macular edema
H34.8311 Tributary (branch) retinal vein occlusion, right eye, with retinal neovascularization
H34.8312 Tributary (branch) retinal vein occlusion, right eye, stable
H34.8320 Tributary (branch) retinal vein occlusion, left eye, with macular edema
H34.8321 Tributary (branch) retinal vein occlusion, left eye, with retinal neovascularization
H34.8322 Tributary (branch) retinal vein occlusion, left eye, stable
H34.8330 Tributary (branch) retinal vein occlusion, bilateral, with macular edema
H34.8331 Tributary (branch) retinal vein occlusion, bilateral, with retinal neovascularization
H34.8332 Tributary (branch) retinal vein occlusion, bilateral, stable
H34.9 Unspecified retinal vascular occlusion
H35.00 Unspecified background retinopathy
H35.011 Changes in retinal vascular appearance, right eye
H35.012 Changes in retinal vascular appearance, left eye
H35.013 Changes in retinal vascular appearance, bilateral
H35.021 Exudative retinopathy, right eye
H35.022 Exudative retinopathy, left eye
H35.023 Exudative retinopathy, bilateral
H35.031 Hypertensive retinopathy, right eye
H35.032 Hypertensive retinopathy, left eye
H35.033 Hypertensive retinopathy, bilateral
H35.041 Retinal micro-aneurysms, unspecified, right eye
H35.042 Retinal micro-aneurysms, unspecified, left eye
H35.043 Retinal micro-aneurysms, unspecified, bilateral
H35.051 Retinal neovascularization, unspecified, right eye
H35.052 Retinal neovascularization, unspecified, left eye
H35.053 Retinal neovascularization, unspecified, bilateral
H35.061 Retinal vasculitis, right eye
H35.062 Retinal vasculitis, left eye
H35.063 Retinal vasculitis, bilateral
H35.071 Retinal telangiectasis, right eye
H35.072 Retinal telangiectasis, left eye
H35.073 Retinal telangiectasis, bilateral
H35.09 Other intraretinal microvascular abnormalities
H35.101 Retinopathy of prematurity, unspecified, right eye
H35.102 Retinopathy of prematurity, unspecified, left eye
H35.103 Retinopathy of prematurity, unspecified, bilateral
H35.111 Retinopathy of prematurity, stage 0, right eye
H35.112 Retinopathy of prematurity, stage 0, left eye
H35.113 Retinopathy of prematurity, stage 0, bilateral
H35.121 Retinopathy of prematurity, stage 1, right eye
H35.122 Retinopathy of prematurity, stage 1, left eye
H35.123 Retinopathy of prematurity, stage 1, bilateral
H35.131 Retinopathy of prematurity, stage 2, right eye
H35.132 Retinopathy of prematurity, stage 2, left eye
H35.133 Retinopathy of prematurity, stage 2, bilateral
H35.141 Retinopathy of prematurity, stage 3, right eye
H35.142 Retinopathy of prematurity, stage 3, left eye
H35.143 Retinopathy of prematurity, stage 3, bilateral
H35.151 Retinopathy of prematurity, stage 4, right eye
H35.152 Retinopathy of prematurity, stage 4, left eye
H35.153 Retinopathy of prematurity, stage 4, bilateral
H35.161 Retinopathy of prematurity, stage 5, right eye
H35.162 Retinopathy of prematurity, stage 5, left eye
H35.163 Retinopathy of prematurity, stage 5, bilateral
H35.171 Retrolental fibroplasia, right eye
H35.172 Retrolental fibroplasia, left eye
H35.173 Retrolental fibroplasia, bilateral
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
H35.30 Unspecified macular degeneration
H35.3110 Nonexudative age-related macular degeneration, right eye, stage unspecified
H35.3111 Nonexudative age-related macular degeneration, right eye, early dry stage
H35.3112 Nonexudative age-related macular degeneration, right eye, intermediate dry stage
H35.3113 Nonexudative age-related macular degeneration, right eye, advanced atrophic without subfoveal involvement
H35.3114 Nonexudative age-related macular degeneration, right eye, advanced atrophic with subfoveal involvement
H35.3120 Nonexudative age-related macular degeneration, left eye, stage unspecified
H35.3121 Nonexudative age-related macular degeneration, left eye, early dry stage
H35.3122 Nonexudative age-related macular degeneration, left eye, intermediate dry stage
H35.3123 Nonexudative age-related macular degeneration, left eye, advanced atrophic without subfoveal involvement
H35.3124 Nonexudative age-related macular degeneration, left eye, advanced atrophic with subfoveal involvement
H35.3130 Nonexudative age-related macular degeneration, bilateral, stage unspecified
H35.3131 Nonexudative age-related macular degeneration, bilateral, early dry stage
H35.3132 Nonexudative age-related macular degeneration, bilateral, intermediate dry stage
H35.3133 Nonexudative age-related macular degeneration, bilateral, advanced atrophic without subfoveal involvement
H35.3134 Nonexudative age-related macular degeneration, bilateral, advanced atrophic with subfoveal involvement
H35.3210 Exudative age-related macular degeneration, right eye, stage unspecified
H35.3211 Exudative age-related macular degeneration, right eye, with active choroidal neovascularization
H35.3212 Exudative age-related macular degeneration, right eye, with inactive choroidal neovascularization
H35.3213 Exudative age-related macular degeneration, right eye, with inactive scar
H35.3220 Exudative age-related macular degeneration, left eye, stage unspecified
H35.3221 Exudative age-related macular degeneration, left eye, with active choroidal neovascularization
H35.3222 Exudative age-related macular degeneration, left eye, with inactive choroidal neovascularization
H35.3223 Exudative age-related macular degeneration, left eye, with inactive scar
H35.3230 Exudative age-related macular degeneration, bilateral, stage unspecified
H35.3231 Exudative age-related macular degeneration, bilateral, with active choroidal neovascularization
H35.3232 Exudative age-related macular degeneration, bilateral, with inactive choroidal neovascularization
H35.3233 Exudative age-related macular degeneration, bilateral, with inactive scar
H35.33 Angioid streaks of macula
H35.341 Macular cyst, hole, or pseudohole, right eye
H35.342 Macular cyst, hole, or pseudohole, left eye
H35.343 Macular cyst, hole, or pseudohole, bilateral
H35.351 Cystoid macular degeneration, right eye
H35.352 Cystoid macular degeneration, left eye
H35.353 Cystoid macular degeneration, bilateral
H35.361 Drusen (degenerative) of macula, right eye
H35.362 Drusen (degenerative) of macula, left eye
H35.363 Drusen (degenerative) of macula, bilateral
H35.371 Puckering of macula, right eye
H35.372 Puckering of macula, left eye
H35.373 Puckering of macula, bilateral
H35.381 Toxic maculopathy, right eye
H35.382 Toxic maculopathy, left eye
H35.383 Toxic maculopathy, bilateral
H35.40 Unspecified peripheral retinal degeneration
H35.411 Lattice degeneration of retina, right eye
H35.412 Lattice degeneration of retina, left eye
H35.413 Lattice degeneration of retina, bilateral
H35.421 Microcystoid degeneration of retina, right eye
H35.422 Microcystoid degeneration of retina, left eye
H35.423 Microcystoid degeneration of retina, bilateral
H35.431 Paving stone degeneration of retina, right eye
H35.432 Paving stone degeneration of retina, left eye
H35.433 Paving stone degeneration of retina, bilateral
H35.441 Age-related reticular degeneration of retina, right eye
H35.442 Age-related reticular degeneration of retina, left eye
H35.443 Age-related reticular degeneration of retina, bilateral
H35.451 Secondary pigmentary degeneration, right eye
H35.452 Secondary pigmentary degeneration, left eye
H35.453 Secondary pigmentary degeneration, bilateral
H35.461 Secondary vitreoretinal degeneration, right eye
H35.462 Secondary vitreoretinal degeneration, left eye
H35.463 Secondary vitreoretinal degeneration, bilateral
H35.50 Unspecified hereditary retinal dystrophy
H35.51 Vitreoretinal dystrophy
H35.52 Pigmentary retinal dystrophy
H35.53 Other dystrophies primarily involving the sensory retina
H35.54 Dystrophies primarily involving the retinal pigment epithelium
H35.61 Retinal hemorrhage, right eye
H35.62 Retinal hemorrhage, left eye
H35.63 Retinal hemorrhage, bilateral
H35.70 Unspecified separation of retinal layers
H35.711 Central serous chorioretinopathy, right eye
H35.712 Central serous chorioretinopathy, left eye
H35.713 Central serous chorioretinopathy, bilateral
H35.721 Serous detachment of retinal pigment epithelium, right eye
H35.722 Serous detachment of retinal pigment epithelium, left eye
H35.723 Serous detachment of retinal pigment epithelium, bilateral
H35.731 Hemorrhagic detachment of retinal pigment epithelium, right eye
H35.732 Hemorrhagic detachment of retinal pigment epithelium, left eye
H35.733 Hemorrhagic detachment of retinal pigment epithelium, bilateral
H35.81 Retinal edema
H35.82 Retinal ischemia
H35.89 Other specified retinal disorders
H36 Retinal disorders in diseases classified elsewhere
H44.2A1 Degenerative myopia with choroidal neovascularization, right eye
H44.2A2 Degenerative myopia with choroidal neovascularization, left eye
H44.2A3 Degenerative myopia with choroidal neovascularization, bilateral eye
H44.2B1 Degenerative myopia with macular hole, right eye
H44.2B2 Degenerative myopia with macular hole, left eye
H44.2B3 Degenerative myopia with macular hole, bilateral eye
H44.2C1 Degenerative myopia with retinal detachment, right eye
H44.2C2 Degenerative myopia with retinal detachment, left eye
H44.2C3 Degenerative myopia with retinal detachment, bilateral eye
H44.2D1 Degenerative myopia with foveoschisis, right eye
H44.2D2 Degenerative myopia with foveoschisis, left eye
H44.2D3 Degenerative myopia with foveoschisis, bilateral eye
H44.2E1 Degenerative myopia with other maculopathy, right eye
H44.2E2 Degenerative myopia with other maculopathy, left eye
H44.2E3 Degenerative myopia with other maculopathy, bilateral eye
H46.01 Optic papillitis, right eye
H46.02 Optic papillitis, left eye
H46.03 Optic papillitis, bilateral
H46.11 Retrobulbar neuritis, right eye
H46.12 Retrobulbar neuritis, left eye
H46.13 Retrobulbar neuritis, bilateral
H46.2 Nutritional optic neuropathy
H46.3 Toxic optic neuropathy
H46.8 Other optic neuritis
H46.9 Unspecified optic neuritis
H47.011 Ischemic optic neuropathy, right eye
H47.012 Ischemic optic neuropathy, left eye
H47.013 Ischemic optic neuropathy, bilateral
H47.021 Hemorrhage in optic nerve sheath, right eye
H47.022 Hemorrhage in optic nerve sheath, left eye
H47.023 Hemorrhage in optic nerve sheath, bilateral
H47.031 Optic nerve hypoplasia, right eye
H47.032 Optic nerve hypoplasia, left eye
H47.033 Optic nerve hypoplasia, bilateral
H47.091 Other disorders of optic nerve, not elsewhere classified, right eye
H47.092 Other disorders of optic nerve, not elsewhere classified, left eye
H47.093 Other disorders of optic nerve, not elsewhere classified, bilateral
H47.10 Unspecified papilledema
H47.11 Papilledema associated with increased intracranial pressure
H47.12 Papilledema associated with decreased ocular pressure
H47.13 Papilledema associated with retinal disorder
H47.141 Foster-Kennedy syndrome, right eye
H47.142 Foster-Kennedy syndrome, left eye
H47.143 Foster-Kennedy syndrome, bilateral
H47.20 Unspecified optic atrophy
H47.211 Primary optic atrophy, right eye
H47.212 Primary optic atrophy, left eye
H47.213 Primary optic atrophy, bilateral
H47.22 Hereditary optic atrophy
H47.231 Glaucomatous optic atrophy, right eye
H47.232 Glaucomatous optic atrophy, left eye
H47.233 Glaucomatous optic atrophy, bilateral
H47.291 Other optic atrophy, right eye
H47.292 Other optic atrophy, left eye
H47.293 Other optic atrophy, bilateral
H47.311 Coloboma of optic disc, right eye
H47.312 Coloboma of optic disc, left eye
H47.313 Coloboma of optic disc, bilateral
H47.321 Drusen of optic disc, right eye
H47.322 Drusen of optic disc, left eye
H47.323 Drusen of optic disc, bilateral
H47.331 Pseudopapilledema of optic disc, right eye
H47.332 Pseudopapilledema of optic disc, left eye
H47.333 Pseudopapilledema of optic disc, bilateral
H47.391 Other disorders of optic disc, right eye
H47.392 Other disorders of optic disc, left eye
H47.393 Other disorders of optic disc, bilateral
H53.10 Unspecified subjective visual disturbances
H53.11 Day blindness
H53.121 Transient visual loss, right eye
H53.122 Transient visual loss, left eye
H53.123 Transient visual loss, bilateral
H53.131 Sudden visual loss, right eye
H53.132 Sudden visual loss, left eye
H53.133 Sudden visual loss, bilateral
H53.15 Visual distortions of shape and size
H53.16 Psychophysical visual disturbances
H53.19 Other subjective visual disturbances
H53.411 Scotoma involving central area, right eye
H53.412 Scotoma involving central area, left eye
H53.413 Scotoma involving central area, bilateral
H53.451 Other localized visual field defect, right eye
H53.452 Other localized visual field defect, left eye
H53.453 Other localized visual field defect, bilateral
H53.51 Achromatopsia
H53.52 Acquired color vision deficiency
H53.60 Unspecified night blindness
H53.61 Abnormal dark adaptation curve
H53.62 Acquired night blindness
H53.63 Congenital night blindness
H53.69 Other night blindness
H53.71 Glare sensitivity
H53.72 Impaired contrast sensitivity
H53.8 Other visual disturbances
H53.9 Unspecified visual disturbance
H54.0X33 Blindness right eye category 3, blindness left eye category 3
H54.0X34 Blindness right eye category 3, blindness left eye category 4
H54.0X35 Blindness right eye category 3, blindness left eye category 5
H54.0X43 Blindness right eye category 4, blindness left eye category 3
H54.0X44 Blindness right eye category 4, blindness left eye category 4
H54.0X45 Blindness right eye category 4, blindness left eye category 5
H54.0X53 Blindness right eye category 5, blindness left eye category 3
H54.0X54 Blindness right eye category 5, blindness left eye category 4
H54.0X55 Blindness right eye category 5, blindness left eye category 5
H54.1131 Blindness right eye category 3, low vision left eye category 1
H54.1132 Blindness right eye category 3, low vision left eye category 2
H54.1141 Blindness right eye category 4, low vision left eye category 1
H54.1142 Blindness right eye category 4, low vision left eye category 2
H54.1151 Blindness right eye category 5, low vision left eye category 1
H54.1152 Blindness right eye category 5, low vision left eye category 2
H54.1213 Low vision right eye category 1, blindness left eye category 3
H54.1214 Low vision right eye category 1, blindness left eye category 4
H54.1215 Low vision right eye category 1, blindness left eye category 5
H54.1223 Low vision right eye category 2, blindness left eye category 3
H54.1224 Low vision right eye category 2, blindness left eye category 4
H54.1225 Low vision right eye category 2, blindness left eye category 5
H54.2X11 Low vision right eye category 1, low vision left eye category 1
H54.2X12 Low vision right eye category 1, low vision left eye category 2
H54.2X21 Low vision right eye category 2, low vision left eye category 1
H54.2X22 Low vision right eye category 2, low vision left eye category 2
H54.413A Blindness right eye category 3, normal vision left eye
H54.414A Blindness right eye category 4, normal vision left eye
H54.415A Blindness right eye category 5, normal vision left eye
H54.42A3 Blindness left eye category 3, normal vision right eye
H54.42A4 Blindness left eye category 4, normal vision right eye
H54.42A5 Blindness left eye category 5, normal vision right eye
H54.511A Low vision right eye category 1, normal vision left eye
H54.512A Low vision right eye category 2, normal vision left eye
H54.52A1 Low vision left eye category 1, normal vision right eye
H54.52A2 Low vision left eye category 2, normal vision right eye
H54.7 Unspecified visual loss
S04.011A - S04.011S Injury of optic nerve, right eye, initial encounter - Injury of optic nerve, right eye, sequela
S04.012A - S04.012S Injury of optic nerve, left eye, initial encounter - Injury of optic nerve, left eye, sequela
S05.51XA - S05.51XS Penetrating wound with foreign body of right eyeball, initial encounter - Penetrating wound with foreign body of right eyeball, sequela
S05.52XA - S05.52XS Penetrating wound with foreign body of left eyeball, initial encounter - Penetrating wound with foreign body of left eyeball, sequela
Z79.899 Other long term (current) drug therapy
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ICD-10-CM Codes that DO NOT Support Medical Necessity

Group 1

(1 Code)
Group 1 Paragraph

All those not listed under the “ICD-10 Codes that are Covered” section of this article.

Group 1 Codes
Code Description
XX000 Not Applicable
N/A

ICD-10-PCS Codes

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

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Additional ICD-10 Information

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Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

Code Description
999x Not Applicable
N/A

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

Code Description
99999 Not Applicable
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Other Coding Information

Group 1

Group 1 Paragraph

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Group 1 Codes

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Coding Table Information

Excluded CPT/HCPCS Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
N/A N/A
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Non-Excluded CPT/HCPCS Ended Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
N/A

Revision History Information

Revision History Date Revision History Number Revision History Explanation
11/21/2019 R1

Article revised and published on 11/21/2019. Due to system changes the order of the Coding Section has been revised and new sections for CPT/HCPCS Modifiers and Other Coding Information have been added.

 

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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related Local Coverage Documents
LCDs
L37371 - Electroretinography (ERG)
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