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

ICD-10 H35.052

Billable / Specific

Retinal neovascularization, unspecified, left eye

H35
Block
0
Synonyms
134
LCDs
26
Payer Policies
0
Linked CPTs

About ICD-10-CM H35.052

ICD-10-CM code H35.052 represents Retinal neovascularization, unspecified, left eye. This is a billable/specific code in the Eye and Adnexa chapter (block H35). The 2026 edition of ICD-10-CM H35.052 became effective on October 1, 2025.

Medicare LCD Coverage for H35.052

Local Coverage Determinations (LCDs) from CMS MACs that list H35.052 as a covered diagnosis.

134 LCDs

Showing top 10 of 134 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: Ranibizumab and biosimilars, Aflibercept, Aflibercept HD, Brolucizumab-dbll, Faricimab-svoa, PAVBLU�aflibercept-ayyh, AHZANTIVE�aflibercept-abzv. ENZEEVU�aflibercept-mrbb, OPUVIZ�aflibercept-yszy and YESAFILI� aflibercept-jbvf
Article ID: 52451, Effective: 2026-01-01 00:00:00, 230 covered, 0 non-covered
CPT Q5147 →
CMS LCD: Billing and Coding: Ranibizumab and biosimilars, Aflibercept, Aflibercept HD, Brolucizumab-dbll, Faricimab-svoa, PAVBLU�aflibercept-ayyh, AHZANTIVE�aflibercept-abzv. ENZEEVU�aflibercept-mrbb, OPUVIZ�aflibercept-yszy and YESAFILI� aflibercept-jbvf
Article ID: 52451, Effective: 2026-01-01 00:00:00, 230 covered, 0 non-covered
CPT Q5124 →
CMS LCD: Billing and Coding: Ranibizumab and biosimilars, Aflibercept, Aflibercept HD, Brolucizumab-dbll, Faricimab-svoa, PAVBLU�aflibercept-ayyh, AHZANTIVE�aflibercept-abzv. ENZEEVU�aflibercept-mrbb, OPUVIZ�aflibercept-yszy and YESAFILI� aflibercept-jbvf
Article ID: 52451, Effective: 2026-01-01 00:00:00, 230 covered, 0 non-covered
CPT Q5150 →
CMS LCD: Billing and Coding: Ranibizumab and biosimilars, Aflibercept, Aflibercept HD, Brolucizumab-dbll, Faricimab-svoa, PAVBLU�aflibercept-ayyh, AHZANTIVE�aflibercept-abzv. ENZEEVU�aflibercept-mrbb, OPUVIZ�aflibercept-yszy and YESAFILI� aflibercept-jbvf
Article ID: 52451, Effective: 2026-01-01 00:00:00, 230 covered, 0 non-covered
CPT J0177 →
CMS LCD: Billing and Coding: Ranibizumab and biosimilars, Aflibercept, Aflibercept HD, Brolucizumab-dbll, Faricimab-svoa, PAVBLU�aflibercept-ayyh, AHZANTIVE�aflibercept-abzv. ENZEEVU�aflibercept-mrbb, OPUVIZ�aflibercept-yszy and YESAFILI� aflibercept-jbvf
Article ID: 52451, Effective: 2026-01-01 00:00:00, 230 covered, 0 non-covered
CPT 67027 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing H35.052.

26 policies

5 Medicare

Billing and Coding: Bevacizumab and biosimilars
Policy ID: ART-52370
Billing and Coding: Ranibizumab and biosimilars, Aflibercept, Aflibercept HD, Brolucizumab-dbll, Faricimab-svoa, PAVBLU�aflibercept-ayyh, AHZANTIVE�aflibercept-abzv. ENZEEVU�aflibercept-mrbb, OPUVIZ�a
Policy ID: ART-52451
Billing and Coding: Intraocular Bevacizumab
Policy ID: ART-53008
Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Policy ID: ART-53060
Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Policy ID: ART-56537

CPT Codes Commonly Billed with H35.052

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

No procedure linkages on file for H35.052

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 H35.052 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
H35.052 36216 10000

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

ICD-10 H35.052, Billing FAQ

Is ICD-10 code H35.052 billable? +

Yes, H35.052 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What ICD-9 codes does H35.052 map to? +

Per CMS GEMs, H35.052 maps to ICD-9 codes: 36216. 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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