H35.029 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools

ICD-10-CM Code View

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Code lookupH35.029

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of choroid and retina (H30-H36)

H35.029

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Exudative retinopathy, unspecified eye

Leakage of fluid from damaged blood vessels in the retina when the specific eye is not identified.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

H35.0Background retinopathy and retinal vascular changes H35.02Exudative retinopathy H35.029Exudative retinopathy, unspecified eye

Inclusion Terms

Official

Coats retinopathyInherited from H35.02

Excludes 2

Official

certain conditions originating in the perinatal period (P04-P96)Inherited from H00-H59, H35
certain infectious and parasitic diseases (A00-B99)Inherited from H00-H59, H35
complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from H00-H59, H35
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from H00-H59, H35
diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)Inherited from H00-H59, H35
endocrine, nutritional and metabolic diseases (E00-E88)Inherited from H00-H59, H35
injury (trauma) of eye and orbit (S05.-)Inherited from H00-H59, H35
injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from H00-H59, H35
neoplasms (C00-D49)Inherited from H00-H59, H35
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from H00-H59, H35
syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)Inherited from H00-H59, H35
diabetic retinal disorders (E08.311-E08.359, E09.311-E09.359, E10.311-E10.359, E11.311-E11.359, E13.311-E13.359)Inherited from H00-H59, H35

Related Codes

Official

H35.021Exudative retinopathy, right eye H35.022Exudative retinopathy, left eye H35.023Exudative retinopathy, bilateral

Includes

Official

No Includes notes are included in this display for H35.029. Check the code and parent instructions in the Code Book.

Excludes 1

Official

No Excludes 1 notes are included in this display for H35.029. Check the code and parent instructions in the Code Book.

Code First

Official

No Code First sequencing instructions are included in this display for H35.029. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for H35.029. Check the code and parent instructions in the Code Book.

Code Also

Official

any associated hypertension (I10)Inherited from H35.0

Buddy Documentation Tip

HCC Buddy guidance

This unspecified laterality code should be avoided; query the provider to determine which eye(s) are affected

Document the underlying etiology and attempt to obtain specific eye laterality information

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is H35.029 an HCC code?

No. H35.029 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code: H35.029
Description: Exudative retinopathy, unspecified eye
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

Coder workflow notes

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What This Code Means

H35.029 is the ICD-10-CM diagnosis code for exudative retinopathy, unspecified eye. Leakage of fluid from damaged blood vessels in the retina when the specific eye is not identified. H35.029 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).

H35.029 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

This unspecified laterality code should be avoided; query the provider to determine which eye(s) are affected.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for H35.029 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This unspecified laterality code should be avoided; query the provider to determine which eye(s) are affected
•Document the underlying etiology and attempt to obtain specific eye laterality information