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

ICD-10 H34.233

Billable / Specific CC

Retinal artery branch occlusion, bilateral

H34
Block
0
Synonyms
330
LCDs
38
Payer Policies
0
Linked CPTs

About ICD-10-CM H34.233

ICD-10-CM code H34.233 represents Retinal artery branch occlusion, bilateral. This is a billable/specific code in the Eye and Adnexa chapter (block H34). The 2026 edition of ICD-10-CM H34.233 became effective on October 1, 2025.

Coding Tips for H34.233

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

Inpatient DRG impact: CC

H34.233 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 Retinal artery branch occlusion, bilateral. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for H34.233

Local Coverage Determinations (LCDs) from CMS MACs that list H34.233 as a covered diagnosis.

330 LCDs

Showing top 10 of 330 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: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8918 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8936 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8910 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT 70548 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8913 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing H34.233.

38 policies

2 Cigna

Ambulatory External and Implantable Electrocardiographic Monitoring - (0547)
Policy ID: MM_0547
Duplex Scan of Extracranial Arteries - (0542)
Policy ID: MM_0542

5 Medicare

Billing and Coding: Non-Invasive Cerebrovascular Arterial Studies
Policy ID: ART-52992
Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Policy ID: ART-53060
Billing and Coding: Transesophageal Echocardiography (TEE)
Policy ID: ART-56505
Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Policy ID: ART-56537
Billing and Coding: Panretinal (Scatter) Laser Photocoagulation
Policy ID: ART-56550

CPT Codes Commonly Billed with H34.233

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

No procedure linkages on file for H34.233

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 H34.233 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
H34.233 36232 10000

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

ICD-10 H34.233, Billing FAQ

Is ICD-10 code H34.233 billable? +

Yes, H34.233 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is H34.233 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 H34.233 map to? +

Per CMS GEMs, H34.233 maps to ICD-9 codes: 36232. 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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