H33.331 ICD-10-CM Code: Multiple defects of retina without detachment, right eye

H33.331 is the ICD-10-CM diagnosis code for multiple defects of retina without detachment, right eye. Multiple breaks, holes, or tears in the retina of the right eye that have not caused the retina to detach. H33.331 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).

H33.331 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.

This code indicates more than one retinal defect; ensure documentation supports multiple breaks rather than a single break.