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

ICD-10 H33.20

Billable / Specific CC

Serous retinal detachment, unspecified eye

H33
Block
0
Synonyms
15
LCDs
4
Payer Policies
0
Linked CPTs

About ICD-10-CM H33.20

ICD-10-CM code H33.20 represents Serous retinal detachment, unspecified eye. This is a billable/specific code in the Eye and Adnexa chapter (block H33). The 2026 edition of ICD-10-CM H33.20 became effective on October 1, 2025.

Coding Tips for H33.20

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

Inpatient DRG impact: CC

H33.20 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 Serous retinal detachment, unspecified eye. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for H33.20

Local Coverage Determinations (LCDs) from CMS MACs that list H33.20 as a covered diagnosis.

15 LCDs

Showing top 10 of 15 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Visual Fields Testing
Article ID: 56799, Effective: 2025-11-06 00:00:00, 1501 covered, 0 non-covered
CPT 92082 →
CMS LCD: Billing and Coding: Visual Fields Testing
Article ID: 56799, Effective: 2025-11-06 00:00:00, 1501 covered, 0 non-covered
CPT 92083 →
CMS LCD: Billing and Coding: Visual Fields Testing
Article ID: 56799, Effective: 2025-11-06 00:00:00, 1501 covered, 0 non-covered
CPT 92081 →
CMS LCD: Billing and Coding: Visual Field Examination
Article ID: 57637, Effective: 2025-10-01 00:00:00, 2832 covered, 1 non-covered
CPT 92082 →
CMS LCD: Billing and Coding: Visual Field Examination
Article ID: 57637, Effective: 2025-10-01 00:00:00, 2832 covered, 1 non-covered
CPT 92083 →
CMS LCD: Billing and Coding: Visual Field Examination
Article ID: 57637, Effective: 2025-10-01 00:00:00, 2832 covered, 1 non-covered
CPT 92081 →
CMS LCD: Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
Article ID: 57071, Effective: 2025-11-06 00:00:00, 1698 covered, 0 non-covered
CPT 92201 →
CMS LCD: Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
Article ID: 57071, Effective: 2025-11-06 00:00:00, 1698 covered, 0 non-covered
CPT 92250 →
CMS LCD: Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
Article ID: 57071, Effective: 2025-11-06 00:00:00, 1698 covered, 0 non-covered
CPT 92202 →
CMS LCD: Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
Article ID: 57071, Effective: 2025-11-06 00:00:00, 1698 covered, 0 non-covered
CPT 92227 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing H33.20.

4 policies

4 Medicare

Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Policy ID: ART-56537
Billing and Coding: Visual Fields Testing
Policy ID: ART-56799
Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
Policy ID: ART-57071
Billing and Coding: Visual Field Examination
Policy ID: ART-57637

CPT Codes Commonly Billed with H33.20

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

No procedure linkages on file for H33.20

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 H33.20 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
H33.20 3612 10000

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

ICD-10 H33.20, Billing FAQ

Is ICD-10 code H33.20 billable? +

Yes, H33.20 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is H33.20 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 H33.20 map to? +

Per CMS GEMs, H33.20 maps to ICD-9 codes: 3612. 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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