H34.10 — Central retinal artery occlusion, unspecified eye
Is H34.10 billable?
Yes, but H34.10 will trip a Medicare edit. H34.10 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists H34.10 under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.
H34.10 at a glance
| Code | H34.10 |
|---|---|
| Description | Central retinal artery occlusion, unspecified eye |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to H34.10?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name H34.10 directly.
A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.
Which MS-DRGs does H34.10 group to?
H34.10 sits in MDC 02 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 124Other Disorders of the Eye with MCC or Thrombolytic Agentmedical
- 125Other Disorders of the Eye without MCCmedical
As a secondary diagnosis, H34.10 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is H34.10 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under H34.1, the nearest indexed parent of H34.10. Use them to find the family, then select the specific code.
- Occlusion, occluded › artery › retinal › central
Excludes1 — never code together — inherited from H34
The conditions below can never be reported together with H34.10 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- amaurosis fugax (G45.3)
Excludes2 — not included here — inherited from Chapter 7
The conditions below are not part of H34.10, but a patient may have both at the same time. When documentation supports it, H34.10 and the excluded code may both 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)
How long has H34.10 existed?
H34.10 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.