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

ICD-10 H59.313

Billable / Specific CC

Postprocedural hemorrhage of eye and adnexa following an ophthalmic procedure, bilateral

H59
Block
0
Synonyms
62
LCDs
3
Payer Policies
0
Linked CPTs

About ICD-10-CM H59.313

ICD-10-CM code H59.313 represents Postprocedural hemorrhage of eye and adnexa following an ophthalmic procedure, bilateral. This is a billable/specific code in the Eye and Adnexa chapter (block H59). The 2026 edition of ICD-10-CM H59.313 became effective on October 1, 2025.

Coding Tips for H59.313

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

Inpatient DRG impact: CC

H59.313 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 Postprocedural hemorrhage of eye and adnexa following an ophthalmic procedure, bilateral. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for H59.313

Local Coverage Determinations (LCDs) from CMS MACs that list H59.313 as a covered diagnosis.

62 LCDs

Showing top 10 of 62 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Non-Invasive Vascular Studies
Article ID: 56697, Effective: 2025-11-06 00:00:00, 1440 covered, 0 non-covered
CPT 93924 →
CMS LCD: Billing and Coding: Non-Invasive Vascular Studies
Article ID: 56697, Effective: 2025-11-06 00:00:00, 1440 covered, 0 non-covered
CPT 93925 →
CMS LCD: Billing and Coding: Non-Invasive Vascular Studies
Article ID: 56697, Effective: 2025-11-06 00:00:00, 1440 covered, 0 non-covered
CPT 93978 →
CMS LCD: Billing and Coding: Non-Invasive Vascular Studies
Article ID: 56697, Effective: 2025-11-06 00:00:00, 1440 covered, 0 non-covered
CPT 93893 →
CMS LCD: Billing and Coding: Non-Invasive Vascular Studies
Article ID: 56697, Effective: 2025-11-06 00:00:00, 1440 covered, 0 non-covered
CPT 93986 →
CMS LCD: Billing and Coding: Non-Invasive Vascular Studies
Article ID: 56697, Effective: 2025-11-06 00:00:00, 1440 covered, 0 non-covered
CPT 93985 →
CMS LCD: Billing and Coding: Non-Invasive Vascular Studies
Article ID: 56697, Effective: 2025-11-06 00:00:00, 1440 covered, 0 non-covered
CPT 93922 →
CMS LCD: Billing and Coding: Non-Invasive Vascular Studies
Article ID: 56697, Effective: 2025-11-06 00:00:00, 1440 covered, 0 non-covered
CPT 93990 →
CMS LCD: Billing and Coding: Non-Invasive Vascular Studies
Article ID: 56697, Effective: 2025-11-06 00:00:00, 1440 covered, 0 non-covered
CPT 93923 →
CMS LCD: Billing and Coding: Non-Invasive Vascular Studies
Article ID: 56697, Effective: 2025-11-06 00:00:00, 1440 covered, 0 non-covered
CPT 93880 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing H59.313.

3 policies

3 Medicare

Billing and Coding: CT of the Head
Policy ID: ART-56612
Billing and Coding: Non-Invasive Vascular Studies
Policy ID: ART-56697
Billing and Coding: MRI and CT Scans of the Head and Neck
Policy ID: ART-57204

CPT Codes Commonly Billed with H59.313

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

No procedure linkages on file for H59.313

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 H59.313 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
H59.313 99811 10000

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

Codes Adjacent To H59.313

Other codes in section H59 (Intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified).

H59 Intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified (non-billable) H59.0 Disorders of the eye following cataract surgery (non-billable) H59.01 Keratopathy (bullous aphakic) following cataract surgery (non-billable) H59.011 Keratopathy (bullous aphakic) following cataract surgery, right eye H59.012 Keratopathy (bullous aphakic) following cataract surgery, left eye H59.013 Keratopathy (bullous aphakic) following cataract surgery, bilateral H59.019 Keratopathy (bullous aphakic) following cataract surgery, unspecified eye H59.02 Cataract (lens) fragments in eye following cataract surgery (non-billable) H59.021 Cataract (lens) fragments in eye following cataract surgery, right eye H59.022 Cataract (lens) fragments in eye following cataract surgery, left eye H59.023 Cataract (lens) fragments in eye following cataract surgery, bilateral H59.029 Cataract (lens) fragments in eye following cataract surgery, unspecified eye H59.03 Cystoid macular edema following cataract surgery (non-billable) H59.031 Cystoid macular edema following cataract surgery, right eye H59.032 Cystoid macular edema following cataract surgery, left eye H59.033 Cystoid macular edema following cataract surgery, bilateral H59.039 Cystoid macular edema following cataract surgery, unspecified eye H59.09 Other disorders of the eye following cataract surgery (non-billable) H59.091 Other disorders of the right eye following cataract surgery H59.092 Other disorders of the left eye following cataract surgery

ICD-10 H59.313, Billing FAQ

Is ICD-10 code H59.313 billable? +

Yes, H59.313 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is H59.313 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 H59.313 map to? +

Per CMS GEMs, H59.313 maps to ICD-9 codes: 99811. 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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