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

ICD-10 H35.30

Billable / Specific

Unspecified macular degeneration

H35
Block
1
Synonyms
59
LCDs
17
Payer Policies
1
Linked CPTs

About ICD-10-CM H35.30

ICD-10-CM code H35.30 represents Unspecified macular degeneration. This is a billable/specific code in the Eye and Adnexa chapter (block H35). The 2026 edition of ICD-10-CM H35.30 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under H35.30. Per CMS ICD-10-CM Tabular 2026.

  • Age-related macular degeneration

Medicare LCD Coverage for H35.30

Local Coverage Determinations (LCDs) from CMS MACs that list H35.30 as a covered diagnosis.

59 LCDs

Showing top 10 of 59 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: Electroretinography (ERG)
Article ID: 57677, Effective: 2024-10-01 00:00:00, 653 covered, 1 non-covered
CPT 92274 →
CMS LCD: Billing and Coding: Electroretinography (ERG)
Article ID: 57677, Effective: 2024-10-01 00:00:00, 653 covered, 1 non-covered
CPT 0509T →
CMS LCD: Billing and Coding: Electroretinography (ERG)
Article ID: 57677, Effective: 2024-10-01 00:00:00, 653 covered, 1 non-covered
CPT 92273 →
CMS LCD: Billing and Coding: Ophthalmic Angiography (Fluorescein and Indocyanine Green)
Article ID: 57069, Effective: 2026-01-15 00:00:00, 595 covered, 206 non-covered
CPT 92240 →
CMS LCD: Billing and Coding: Ophthalmic Angiography (Fluorescein and Indocyanine Green)
Article ID: 57069, Effective: 2026-01-15 00:00:00, 595 covered, 206 non-covered
CPT 92235 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing H35.30.

17 policies

5 Medicare

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
Billing and Coding: Visual Fields Testing
Policy ID: ART-56551
Billing and Coding: Electroretinography (ERG)
Policy ID: ART-56672
Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Policy ID: ART-56692

1 Aetna

Verteporfin (Visudyne) Photodynamic Therapy
Policy ID: CPB-0594

CPT Codes Commonly Billed with H35.30

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

1 linkages
  • 92014 Comprehensive eye exam established — glaucoma, glaucoma suspect, diabetic retinopathy, macular degeneration, routine eye exam, myopia, presbyopia, visual disturbance Ophthalmology

Convert H35.30 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
H35.30 36250 00000

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

ICD-10 H35.30, Billing FAQ

Is ICD-10 code H35.30 billable? +

Yes, H35.30 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to H35.30? +

ICD-10 H35.30 includes: Age-related macular degeneration.

What CPT codes are commonly billed with H35.30? +

Procedures frequently paired with H35.30 include: 92014.

What ICD-9 codes does H35.30 map to? +

Per CMS GEMs, H35.30 maps to ICD-9 codes: 36250. 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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