ICD-10 H35.81
Billable / SpecificRetinal edema
About ICD-10-CM H35.81
ICD-10-CM code H35.81 represents Retinal edema. This is a billable/specific code in the Eye and Adnexa chapter (block H35). The 2026 edition of ICD-10-CM H35.81 became effective on October 1, 2025.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under H35.81. Per CMS ICD-10-CM Tabular 2026.
- Retinal cotton wool spots
Medicare LCD Coverage for H35.81
Local Coverage Determinations (LCDs) from CMS MACs that list H35.81 as a covered diagnosis.
Showing top 10 of 166 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing H35.81.
1 Cigna
5 Medicare
CPT Codes Commonly Billed with H35.81
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 67028 Intravitreal injection — wet AMD, macular degeneration, diabetic macular edema, diabetic retinopathy, retinal vein occlusion Ophthalmology
- 67028 Intravitreal injection — wet/dry AMD all stages both eyes, diabetic macular edema, diabetic retinopathy, retinal vein occlusion, macular edema Ophthalmology
Convert H35.81 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 |
|---|---|---|
| H35.81 | 36283 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To H35.81
Other codes in section H30-H36 (Disorders of choroid and retina).
ICD-10 H35.81, Billing FAQ
Is ICD-10 code H35.81 billable? +
Yes, H35.81 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 H35.81? +
ICD-10 H35.81 includes: Retinal cotton wool spots.
What CPT codes are commonly billed with H35.81? +
Procedures frequently paired with H35.81 include: 67028, 67028.
What ICD-9 codes does H35.81 map to? +
Per CMS GEMs, H35.81 maps to ICD-9 codes: 36283. 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 July 16, 2026.
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