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2025 ICD-10-CM code H35.463

Secondary vitreoretinal degeneration affecting both eyes.

Do not use this code for hereditary retinal dystrophies (H35.5-) or peripheral retinal degeneration with retinal breaks (H33.3-).An external cause code should be used, if applicable, to identify the cause of the eye condition.

Medical necessity must be established by demonstrating the impact of the secondary vitreoretinal degeneration on the patient's vision or ocular health. The underlying condition should also be documented and linked to the retinal degeneration.

In simple words: This refers to a deterioration of the back part of both eyes, specifically the vitreous humor (a gel-like substance) and the retina (the light-sensitive tissue), resulting from a different medical issue.

This code signifies a degenerative condition impacting the vitreous and retinal tissues of both eyes, secondary to another underlying cause.

Example 1: A patient with a history of uveitis develops secondary vitreoretinal degeneration in both eyes., A patient with a history of retinal detachment experiences secondary vitreoretinal degeneration in both eyes after surgical repair., A patient with high myopia develops secondary vitreoretinal degeneration in both eyes over time.

Documentation should support the diagnosis of secondary vitreoretinal degeneration and clearly indicate the underlying cause.Include any relevant history, examination findings (such as ophthalmoscopic examination results), and diagnostic testing.

** Excludes2 notes specify several conditions that should not be coded with H35.463, including certain conditions originating in the perinatal period (P04-P96), certain infectious and parasitic diseases (A00-B99), and diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-).

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