H35.63 ICD-10-CM Code: Retinal hemorrhage, bilateral
H35.63 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of choroid and retina (H30-H36)
H35.63
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceRetinal hemorrhage, bilateral
Bleeding inside the retina occurring in both eyes simultaneously.
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 H35.63 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H35.63 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H35.63 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H35.63 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H35.63 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H35.63 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H35.63 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 H35.63 an HCC code?
No. H35.63 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
- H35.63
- Description
- Retinal hemorrhage, bilateral
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
Get the V28 mapping + MEAT cheat sheet
One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.
Free PDF. No card. Unsubscribe anytime.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
H35.63 is the ICD-10-CM diagnosis code for retinal hemorrhage, bilateral. Bleeding inside the retina occurring in both eyes simultaneously. H35.63 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).
H35.63 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.
Confirm bilateral involvement is explicitly documented in the medical record before coding.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for H35.63 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm bilateral involvement is explicitly documented in the medical record before coding
- •Consider systemic conditions like severe hypertension or bleeding disorders that may cause bilateral presentation