ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 H30.103

Billable / Specific CC

Unspecified disseminated chorioretinal inflammation, bilateral

H30
Block
0
Synonyms
60
LCDs
17
Payer Policies
0
Linked CPTs

About ICD-10-CM H30.103

ICD-10-CM code H30.103 represents Unspecified disseminated chorioretinal inflammation, bilateral. This is a billable/specific code in the Eye and Adnexa chapter (block H30). The 2026 edition of ICD-10-CM H30.103 became effective on October 1, 2025.

Coding Tips for H30.103

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

H30.103 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inpatient DRG Impact, CC

codes Unspecified disseminated chorioretinal inflammation, bilateral. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for H30.103

Local Coverage Determinations (LCDs) from CMS MACs that list H30.103 as a covered diagnosis.

60 LCDs

Showing top 10 of 60 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92201 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92250 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92202 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92227 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92228 →
CMS LCD: Billing and Coding: Electroretinography (ERG)
Article ID: 57677, Effective: 2024-10-01 00:00:00, 653 covered, 1 non-covered
CPT 92274 →
CMS LCD: Billing and Coding: Electroretinography (ERG)
Article ID: 57677, Effective: 2024-10-01 00:00:00, 653 covered, 1 non-covered
CPT 0509T →
CMS LCD: Billing and Coding: Electroretinography (ERG)
Article ID: 57677, Effective: 2024-10-01 00:00:00, 653 covered, 1 non-covered
CPT 92273 →
CMS LCD: Billing and Coding: Ophthalmic Angiography (Fluorescein and Indocyanine Green)
Article ID: 57069, Effective: 2026-01-15 00:00:00, 595 covered, 206 non-covered
CPT 92240 →
CMS LCD: Billing and Coding: Ophthalmic Angiography (Fluorescein and Indocyanine Green)
Article ID: 57069, Effective: 2026-01-15 00:00:00, 595 covered, 206 non-covered
CPT 92235 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing H30.103.

17 policies

5 Medicare

Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Policy ID: ART-53060
Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Policy ID: ART-56537
Billing and Coding: Visual Fields Testing
Policy ID: ART-56551
Billing and Coding: Electroretinography (ERG)
Policy ID: ART-56672
Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Policy ID: ART-56692

CPT Codes Commonly Billed with H30.103

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for H30.103

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert H30.103 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
H30.103 36310 10000
H30.103 36314 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 H30.103, Billing FAQ

Is ICD-10 code H30.103 billable? +

Yes, H30.103 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is H30.103 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What ICD-9 codes does H30.103 map to? +

Per CMS GEMs, H30.103 maps to ICD-9 codes: 36310, 36314. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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