ICD-10 H31.401
Billable / Specific CCUnspecified choroidal detachment, right eye
About ICD-10-CM H31.401
ICD-10-CM code H31.401 represents Unspecified choroidal detachment, right eye. This is a billable/specific code in the Eye and Adnexa chapter (block H31). The 2026 edition of ICD-10-CM H31.401 became effective on October 1, 2025.
Coding Tips for H31.401
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
H31.401 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 choroidal detachment, right eye. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for H31.401
Local Coverage Determinations (LCDs) from CMS MACs that list H31.401 as a covered diagnosis.
Showing top 10 of 56 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing H31.401.
5 Medicare
CPT Codes Commonly Billed with H31.401
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
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 H31.401 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| H31.401 | 36370 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To H31.401
Other codes in section H30-H36 (Disorders of choroid and retina).
ICD-10 H31.401, Billing FAQ
Is ICD-10 code H31.401 billable? +
Yes, H31.401 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is H31.401 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 H31.401 map to? +
Per CMS GEMs, H31.401 maps to ICD-9 codes: 36370. 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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