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H35.169

Billable

Retinopathy of prematurity, stage 5, unspecified eye

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

What This Code Means

The most severe stage of retinopathy of prematurity with complete retinal detachment, but the specific eye(s) affected is not documented.

Coding Tips

  • Use only when laterality is truly unspecified in the medical record
  • Attempt to clarify with provider documentation which eye(s) have stage 5 ROP

Code Hierarchy

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