ICD-10-CM Billable Code

H35.10

Retinopathy of prematurity, unspecified

Clinical Classification Guidelines

Inclusion Terms

  • Retinopathy of prematurity NOS

Medical Intelligence & Overview

Retinopathy of prematurity (ROP) is an eye disorder primarily affecting premature infants, where abnormal blood vessels grow in the retina, the light-sensitive tissue at the back of the eye. When the condition is unspecified, it indicates that detailed classification or severity has not been determined. ROP can potentially lead to vision impairment or blindness if not monitored and managed appropriately, making early awareness and diagnosis crucial for affected infants.

Causes & Symptoms

Clinical Causes: Premature birth, especially before 31 weeks of gestation Low birth weight (less than 1500 grams) Rapid growth of immature blood vessels in the retina Exposure to oxygen therapy in neonatal care settings Genetic factors influencing vascular development in the eye

Key Symptoms: No apparent symptoms in initial stages In cases where symptoms appear, they may include: Strabismus (misalignment of the eyes) Leukocoria (white reflection from the retina, sometimes described as a white pupillary reflex) Poor visual response or tracking Nystagmus (involuntary eye movements)

Diagnostic & Treatment

Diagnosis Path: The diagnosis of retinopathy of prematurity typically involves a comprehensive eye examination conducted by a pediatric ophthalmologist. The screening usually takes place within the first few weeks after birth, especially in infants born prematurely or with low birth weight. The examination may include:

Treatment Protocols: Treatment strategies depend on the severity and progression of the disease. While some cases resolve spontaneously, others may require intervention to prevent vision loss:

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

Documentation

How do I report H35.10?
Clinical documentation must specify the nature of Retinopathy of prematurity, unspecified and any associated comorbidities for accurate reporting.

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