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

ICD-10 H34.219

Billable / Specific CC

Partial retinal artery occlusion, unspecified eye

H34
Block
0
Synonyms
5
LCDs
2
Payer Policies
0
Linked CPTs

About ICD-10-CM H34.219

ICD-10-CM code H34.219 represents Partial retinal artery occlusion, unspecified eye. This is a billable/specific code in the Eye and Adnexa chapter (block H34). The 2026 edition of ICD-10-CM H34.219 became effective on October 1, 2025.

Coding Tips for H34.219

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

Inpatient DRG impact: CC

H34.219 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, unspecified eye. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for H34.219

Local Coverage Determinations (LCDs) from CMS MACs that list H34.219 as a covered diagnosis.

5 LCDs

Showing top 5. Click a CPT for full coverage scope.

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: Non-invasive Extracranial Arterial Studies
Article ID: 57670, Effective: 2025-12-01 00:00:00, 186 covered, 1 non-covered
CPT 93880 →
CMS LCD: Billing and Coding: Non-invasive Extracranial Arterial Studies
Article ID: 57670, Effective: 2025-12-01 00:00:00, 186 covered, 1 non-covered
CPT 93882 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing H34.219.

2 policies

2 Medicare

Billing and Coding: Visual Field Examination
Policy ID: ART-57637
Billing and Coding: Non-invasive Extracranial Arterial Studies
Policy ID: ART-57670

CPT Codes Commonly Billed with H34.219

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

No procedure linkages on file for H34.219

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 H34.219 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
H34.219 36233 10000

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

ICD-10 H34.219, Billing FAQ

Is ICD-10 code H34.219 billable? +

Yes, H34.219 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is H34.219 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 H34.219 map to? +

Per CMS GEMs, H34.219 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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