H35.09 ICD-10-CM Code: Other intraretinal microvascular abnormalities
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of choroid and retina (H30-H36)
H35.09
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther intraretinal microvascular abnormalities
Abnormal tiny blood vessel changes in the retina (the light-sensitive tissue at the back of the eye) that are not classified as other specific types.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Retinal varices
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H35.09 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H35.09 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H35.09 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H35.09 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H35.09 in this effective period.
Code Also
Official- any associated hypertension (I10)
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is H35.09 an HCC code?
No. H35.09 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- H35.09
- Description
- Other intraretinal microvascular abnormalities
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
H35.09 is the ICD-10-CM diagnosis code for other intraretinal microvascular abnormalities. Abnormal tiny blood vessel changes in the retina (the light-sensitive tissue at the back of the eye) that are not classified as other specific types. H35.09 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).
H35.09 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.
Use this code when microvascular abnormalities are documented but don't fit into more specific subcategories like branch retinal artery occlusion or retinal microaneurysms.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H35.09 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code when microvascular abnormalities are documented but don't fit into more specific subcategories like branch retinal artery occlusion or retinal microaneurysms.
- •Ensure documentation specifies which eye is affected; if bilateral, code both eyes separately or use the bilateral code if available.