H43-H44 — Disorders of vitreous body and globe
ICD-10-CM codes H43-H44 cover disorders of vitreous body and globe, within diseases of the eye and adnexa. The block holds 245 codes across 2 categories, of which 188 are billable and 57 are header codes that cannot be submitted on a claim.
Risk adjustment in H43-H44
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 298 Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage
What else to watch in H43-H44
- 90 codes are laterality-specific. They come in left and right pairs, and the pair is mutually exclusive on a single site: coding both without a bilateral code is a contradiction a scrubber should catch before the payer does.
- 184 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.