H31.012 ICD-10-CM Code: Macula scars of posterior pole (postinflammatory) (post-traumatic), left eye

H31.012 is the ICD-10-CM diagnosis code for macula scars of posterior pole (postinflammatory) (post-traumatic), left eye. This code describes scarring of the macula (the central part of the retina responsible for detailed vision) in the left eye that developed after inflammation or injury. These scars can result from conditions like uveitis, retinitis, or eye trauma and may affect central vision. H31.012 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering disorders of choroid and retina (h30-h36).

H31.012 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

Verify the laterality is documented as left eye (H31.012) versus right eye (H31.011) or bilateral (H31.013) to ensure accurate code selection.