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H35.159

Billable

Retinopathy of prematurity, stage 4, unspecified eye

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), but the specific eye affected is not documented.

Coding Tips

  • Use this code only when laterality cannot be determined from medical record documentation
  • Query provider if possible to clarify which eye(s) are affected for more specific coding

Code Hierarchy

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