H35.4 — Peripheral retinal degeneration
Is H35.4 billable?
No — H35.4 is a non-billable header code. H35.4 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 25 billable codes beneath H35.4.
Billable codes under this header
- H35.40Unspecified peripheral retinal degeneration
- H35.411Lattice degeneration of retina, right eye
- H35.412Lattice degeneration of retina, left eye
- H35.413Lattice degeneration of retina, bilateral
- H35.419Lattice degeneration of retina, unspecified eye
- H35.421Microcystoid degeneration of retina, right eye
- H35.422Microcystoid degeneration of retina, left eye
- H35.423Microcystoid degeneration of retina, bilateral
- H35.429Microcystoid degeneration of retina, unspecified eye
- H35.431Paving stone degeneration of retina, right eye
- H35.432Paving stone degeneration of retina, left eye
- H35.433Paving stone degeneration of retina, bilateral
- H35.439Paving stone degeneration of retina, unspecified eye
- H35.441Age-related reticular degeneration of retina, right eye
- H35.442Age-related reticular degeneration of retina, left eye
- H35.443Age-related reticular degeneration of retina, bilateral
- H35.449Age-related reticular degeneration of retina, unspecified eye
- H35.451Secondary pigmentary degeneration, right eye
- H35.452Secondary pigmentary degeneration, left eye
- H35.453Secondary pigmentary degeneration, bilateral
- H35.459Secondary pigmentary degeneration, unspecified eye
- H35.461Secondary vitreoretinal degeneration, right eye
- H35.462Secondary vitreoretinal degeneration, left eye
- H35.463Secondary vitreoretinal degeneration, bilateral
- H35.469Secondary vitreoretinal degeneration, unspecified eye
H35.4 at a glance
| Code | H35.4 |
|---|---|
| Description | Peripheral retinal degeneration |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Excludes1 — never code together
The conditions below can never be reported together with H35.4 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- hereditary retinal degeneration (dystrophy) (H35.5-)
Excludes2 — not included here
The conditions below are not part of H35.4, but a patient may have both at the same time. When documentation supports it, H35.4 and the excluded code may both be reported.
- peripheral retinal degeneration with retinal break (H33.3-)
Excludes2 — not included here — inherited from Chapter 7
The conditions below are not part of H35.4, but a patient may have both at the same time. When documentation supports it, H35.4 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 H35.4, but a patient may have both at the same time. When documentation supports it, H35.4 and the excluded code may both be reported.
What codes fall under H35.4? (7)
- H35.40Unspecified peripheral retinal degeneration
- H35.41Lattice degeneration of retinanot billable
- H35.42Microcystoid degeneration of retinanot billable
- H35.43Paving stone degeneration of retinanot billable
- H35.44Age-related reticular degeneration of retinanot billable
- H35.45Secondary pigmentary degenerationnot billable
- H35.46Secondary vitreoretinal degenerationnot billable
How long has H35.4 existed?
H35.4 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
- H35.1Retinopathy of prematuritynot billable
- H35.2Other non-diabetic proliferative retinopathynot billable
- H35.3Degeneration of macula and posterior polenot 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