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H35.153

Billable

Retinopathy of prematurity, stage 4, bilateral

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

A serious eye condition in premature infants where abnormal blood vessels develop in the retina and have reached stage 4 (severe scarring) in both eyes, potentially leading to vision loss or blindness.

Coding Tips

  • •Stage 4 ROP indicates significant retinal detachment and scarring; ensure documentation specifies bilateral involvement
  • •This code requires a 7th character for laterality; verify bilateral is correctly documented before coding

Code Hierarchy

└H35Other retinal disorders└H35.1Retinopathy of prematurity└H35.15Retinopathy of prematurity, stage 4└H35.153Retinopathy of prematurity, stage 4, bilateral
└H35.153Retinopathy of prematurity, stage 4, bilateral

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