H35.363
BillableDrusen (degenerative) of macula, bilateral
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
Drusen are small yellow or white deposits that accumulate under the retina in the macula (the central part of the eye responsible for detailed vision) in both eyes. This condition is often associated with age-related macular degeneration and can affect vision quality.
Coding Tips
- •Verify that drusen are documented as present in BOTH eyes before assigning the bilateral code (H35.363); if only one eye is affected, use the unilateral codes (H35.361 for right eye or H35.362 for left eye)
- •Confirm whether the drusen are specifically noted as 'degenerative' in the clinical documentation, as this distinguishes them from other types of retinal deposits and supports medical necessity for monitoring and treatment
Code Hierarchy
└H35Other retinal disorders└H35.3Degeneration of macula and posterior pole└H35.36Drusen (degenerative) of macula└H35.363Drusen (degenerative) of macula, bilateral
└H35.363Drusen (degenerative) of macula, bilateral