H59.113 ICD-10-CM Code: Intraoperative hemorrhage and hematoma of eye and adnexa complicating an ophthalmic procedure, bilateral

H59.113 is the ICD-10-CM diagnosis code for intraoperative hemorrhage and hematoma of eye and adnexa complicating an ophthalmic procedure, bilateral. This code describes bleeding that occurs during eye surgery on both eyes, where blood collects in or around the eye tissue as a complication of the surgical procedure. It indicates that the hemorrhage happened during the operation itself, not before or after. H59.113 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified (h59).

H59.113 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

This code requires documentation that the hemorrhage occurred intraoperatively (during the procedure) and affected both eyes; verify the operative report clearly states bilateral involvement.