ICD-10-CM Billable Code

H35.21

Other non-diabetic proliferative retinopathy, right eye

Clinical Classification Guidelines

Medical Intelligence & Overview

Non-diabetic proliferative retinopathy is a condition characterized by abnormal growth of blood vessels in the retina, the light-sensitive tissue at the back of the eye. When this condition occurs in the right eye without diabetes being the cause, it is classified under the ICD-10 code H35.21. This condition involves the growth of new blood vessels that can disrupt vision and potentially lead to more severe eye problems if not monitored and managed properly.

Causes & Symptoms

Clinical Causes: Retinal ischemia (lack of oxygen in the retina, leading to abnormal blood vessel growth) Inherited retinal vascular disorders Inflammatory eye conditions Eye trauma or injury Certain vascular diseases affecting the eye

Key Symptoms: Sudden or gradual loss of vision in the right eye Floaters or spots floating in the visual field Blurred or distorted vision Visual disturbances or shadows across the vision Possible appearance of red or dark areas in the vision

Diagnostic & Treatment

Diagnosis Path: Diagnosis typically involves a comprehensive eye examination, including dilated fundus examination where an eye care professional examines the retina after using eye drops to widen the pupils. Additional tests may include optical coherence tomography (OCT), fluorescein angiography, and other imaging techniques to visualize the retina's blood vessels and assess the extent of abnormal growth and any associated damage.

Treatment Protocols: Laser therapy (photocoagulation) to seal off abnormal blood vessels and prevent further growth Cryotherapy in certain cases to target abnormal vessels Surgical interventions such as vitrectomy to remove blood and scar tissue impairing vision Monitoring and regular eye exams to track disease progression Treatment of underlying conditions or risk factors that may contribute to retinal changes

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.

Clinical Advice & FAQs

Billing Guidance

Is H35.21 a billable ICD-10 code?
Yes, H35.21 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report H35.21?
Clinical documentation must specify the nature of Other non-diabetic proliferative retinopathy, right eye and any associated comorbidities for accurate reporting.

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