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H36.8 ICD-10-CM Code: Other retinal disorders in diseases classified elsewhere

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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of choroid and retina (H30-H36)

H36.8

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Other retinal disorders in diseases classified elsewhere

Other retinal disorders in diseases classified elsewhere

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
H36Retinal disorders in diseases classified elsewhere
H36.8Other retinal disorders in diseases classified elsewhere

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H36.8 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H36.8 in this effective period.

Related Child Codes

Official
H36.81Nonproliferative sickle-cell retinopathy
H36.82Proliferative sickle-cell retinopathy
H36.89Other retinal disorders in diseases classified elsewhere

Includes

Official

ICD-10-CM does not list Includes notes for H36.8 in this effective period.

Excludes 1

Official
  • arteriosclerotic retinopathy (H35.0-)
  • diabetic retinopathy (E08.3-, E09.3-, E10.3-, E11.3-, E13.3-)

Code First

Official
  • underlying disease, such as:
  • lipid storage disorders (E75.-)
  • sickle-cell disorders (D57.-)

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H36.8 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H36.8 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

What This Code Means

H36.8 is the ICD-10-CM diagnosis code for other retinal disorders in diseases classified elsewhere. H36.8 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).

Header codes like H36.8 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at H36.8's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H36.8 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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