H35.129 ICD-10-CM Code: Retinopathy of prematurity, stage 1, unspecified eye
H35.129 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of choroid and retina (H30-H36)
H35.129
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceRetinopathy of prematurity, stage 1, unspecified eye
An eye condition in premature infants where abnormal blood vessels develop in the retina, classified as stage 1 severity, but the specific eye affected is not documented.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for H35.129 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H35.129 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H35.129 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H35.129 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H35.129 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H35.129 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H35.129 in this effective period.
Buddy Documentation Tip
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 H35.129 an HCC code?
No. H35.129 is a billable ICD-10-CM code with no mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- H35.129
- Description
- Retinopathy of prematurity, stage 1, unspecified eye
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- 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
H35.129 is the ICD-10-CM diagnosis code for retinopathy of prematurity, stage 1, unspecified eye. An eye condition in premature infants where abnormal blood vessels develop in the retina, classified as stage 1 severity, but the specific eye affected is not documented. H35.129 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).
H35.129 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28 or V24 community payment models, 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.
Use unspecified eye code only when documentation does not clearly indicate which eye is affected.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for H35.129 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use unspecified eye code only when documentation does not clearly indicate which eye is affected
- •Query the provider if possible to determine laterality, as this affects treatment planning and follow-up