ICD-10 H34.213
Billable / Specific CCPartial retinal artery occlusion, bilateral
About ICD-10-CM H34.213
ICD-10-CM code H34.213 represents Partial retinal artery occlusion, bilateral. This is a billable/specific code in the Eye and Adnexa chapter (block H34). The 2026 edition of ICD-10-CM H34.213 became effective on October 1, 2025.
Coding Tips for H34.213
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
H34.213 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 Partial retinal artery occlusion, bilateral. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for H34.213
Local Coverage Determinations (LCDs) from CMS MACs that list H34.213 as a covered diagnosis.
Showing top 10 of 313 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing H34.213.
2 Cigna
5 Medicare
CPT Codes Commonly Billed with H34.213
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 H34.213 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 |
|---|---|---|
| H34.213 | 36233 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To H34.213
Other codes in section H30-H36 (Disorders of choroid and retina).
ICD-10 H34.213, Billing FAQ
Is ICD-10 code H34.213 billable? +
Yes, H34.213 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is H34.213 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 H34.213 map to? +
Per CMS GEMs, H34.213 maps to ICD-9 codes: 36233. 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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