H35.1 — Retinopathy of prematurity
Is H35.1 billable?
No — H35.1 is a non-billable header code. H35.1 groups more specific codes and cannot be submitted on a claim. A valid ICD-10-CM code must be reported at the highest level of specificity available in its branch. Select one of the 32 billable codes beneath H35.1.
Billable codes under this header
- H35.101Retinopathy of prematurity, unspecified, right eye
- H35.102Retinopathy of prematurity, unspecified, left eye
- H35.103Retinopathy of prematurity, unspecified, bilateral
- H35.109Retinopathy of prematurity, unspecified, unspecified eye
- H35.111Retinopathy of prematurity, stage 0, right eye
- H35.112Retinopathy of prematurity, stage 0, left eye
- H35.113Retinopathy of prematurity, stage 0, bilateral
- H35.119Retinopathy of prematurity, stage 0, unspecified eye
- H35.121Retinopathy of prematurity, stage 1, right eye
- H35.122Retinopathy of prematurity, stage 1, left eye
- H35.123Retinopathy of prematurity, stage 1, bilateral
- H35.129Retinopathy of prematurity, stage 1, unspecified eye
- H35.131Retinopathy of prematurity, stage 2, right eye
- H35.132Retinopathy of prematurity, stage 2, left eye
- H35.133Retinopathy of prematurity, stage 2, bilateral
- H35.139Retinopathy of prematurity, stage 2, unspecified eye
- H35.141Retinopathy of prematurity, stage 3, right eye
- H35.142Retinopathy of prematurity, stage 3, left eye
- H35.143Retinopathy of prematurity, stage 3, bilateral
- H35.149Retinopathy of prematurity, stage 3, unspecified eye
- H35.151Retinopathy of prematurity, stage 4, right eye
- H35.152Retinopathy of prematurity, stage 4, left eye
- H35.153Retinopathy of prematurity, stage 4, bilateral
- H35.159Retinopathy of prematurity, stage 4, unspecified eye
- H35.161Retinopathy of prematurity, stage 5, right eye
- H35.162Retinopathy of prematurity, stage 5, left eye
- H35.163Retinopathy of prematurity, stage 5, bilateral
- H35.169Retinopathy of prematurity, stage 5, unspecified eye
- H35.171Retrolental fibroplasia, right eye
- H35.172Retrolental fibroplasia, left eye
- H35.173Retrolental fibroplasia, bilateral
- H35.179Retrolental fibroplasia, unspecified eye
H35.1 at a glance
| Code | H35.1 |
|---|---|
| Description | Retinopathy of prematurity |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Excludes2 — not included here — inherited from Chapter 7
The conditions below are not part of H35.1, but a patient may have both at the same time. When documentation supports it, H35.1 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)
Excludes2 — not included here — inherited from H35
The conditions below are not part of H35.1, but a patient may have both at the same time. When documentation supports it, H35.1 and the excluded code may both be reported.
What codes fall under H35.1? (8)
- H35.10Retinopathy of prematurity, unspecifiednot billable
- H35.11Retinopathy of prematurity, stage 0not billable
- H35.12Retinopathy of prematurity, stage 1not billable
- H35.13Retinopathy of prematurity, stage 2not billable
- H35.14Retinopathy of prematurity, stage 3not billable
- H35.15Retinopathy of prematurity, stage 4not billable
- H35.16Retinopathy of prematurity, stage 5not billable
- H35.17Retrolental fibroplasianot billable
How long has H35.1 existed?
H35.1 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.
What other codes are in the H35 family? (9)
- H35.0Background retinopathy and retinal vascular changesnot billable
- H35.2Other non-diabetic proliferative retinopathynot billable
- H35.3Degeneration of macula and posterior polenot billable
- H35.4Peripheral retinal degenerationnot billable
- H35.5Hereditary retinal dystrophynot billable
- H35.6Retinal hemorrhagenot billable
- H35.7Separation of retinal layersnot billable
- H35.8Other specified retinal disordersnot billable
- H35.9Unspecified retinal disorder