The ICD-10-CM diagnosis code H35.049 is a critical component in medical coding, specifically used to classify retinal micro-aneurysms, unspecified, in an unspecified eye. This code is essential for accurate medical billing and record-keeping within the healthcare system in the United States and other countries that utilize the ICD-10-CM system.
Understanding ICD-10-CM Code H35.049
H35.049 falls under the category of “Retinal vascular occlusions,” within Chapter VII of the ICD-10-CM, which covers diseases of the eye and adnexa. Specifically, H35.049 denotes retinal micro-aneurysms without specifying laterality (right or left eye). It is designated as a billable/specific code, meaning it is precise enough to be used for reimbursement purposes. The code officially came into effect on October 1, 2015, for the 2016 ICD-10-CM edition, and the current version is for the year 2025, effective from October 1, 2024, with no changes throughout these years, indicating its established and consistent use.
Key Details and Context for H35.049
Within the ICD-10-CM framework, H35.049 is associated with various annotations, including back-references to other codes that may contain related information such as “Applicable To,” “Code Also,” “Code First,” and “Excludes” notes. These annotations provide further guidance for coders to ensure accurate and comprehensive coding practices.
Approximate Synonyms: The code H35.049 is directly synonymous with “retinal microaneurysm,” offering a more concise term for this diagnosis.
Diagnostic Related Group (DRG): ICD-10-CM code H35.049 is categorized under specific Diagnostic Related Groups (MS-DRG v42.0), which are used to classify hospital cases and determine reimbursement levels based on the diagnosis and resources used.
Code History: Reviewing the code history reveals that H35.049 was newly introduced in 2016 and has remained unchanged through the 2025 edition, demonstrating its continued relevance and stability within the ICD-10-CM coding system.
ICD-10-CM Codes Adjacent to H35.049
To provide broader context, codes adjacent to H35.049 in the ICD-10-CM manual include related conditions such as:
- H35.029: Exudative age-related macular degeneration, unspecified eye
- H35.03: Hypertensive retinopathy
- H35.04: Retinal micro-aneurysms, unspecified (more general category)
- H35.05: Retinal neovascularization, unspecified
- H35.06: Retinal vasculitis
These adjacent codes highlight the spectrum of retinal vascular conditions and help differentiate H35.049 from similar diagnoses.
Conclusion
In summary, ICD-10-CM code H35.049 is the designated code for documenting retinal micro-aneurysms when laterality is not specified. Understanding the specifics of this code, its history, and its place within the ICD-10-CM system is crucial for healthcare professionals involved in diagnosis, medical coding, and billing processes. Accurate use of H35.049 ensures correct documentation and reimbursement for patients diagnosed with this ophthalmic condition.
