2025 ICD-10-CM code H59.81

Chorioretinal scars following retinal detachment surgery.

Code H59.81 only when chorioretinal scarring is a direct result of retinal detachment surgery.If other causes of chorioretinal scarring exist, these should be coded separately.Use additional codes for laterality (right or left eye) if applicable.

Modifiers may be applicable depending on the circumstances of the surgery and the payer's guidelines.Consult local coding guidelines.

The medical necessity for coding H59.81 is established by the presence of chorioretinal scarring as a documented complication following a necessary surgical procedure for retinal detachment. The scarring must be directly attributed to the surgical intervention.

Ophthalmologist

IMPORTANT H59.811 (right eye), H59.812 (left eye) are more specific codes to use if laterality is known.Consider additional codes for associated conditions if present.

In simple words: This code describes scar tissue on the retina and choroid (layers of the eye) that developed after an operation to fix a detached retina.

This code signifies the presence of chorioretinal scarring as a complication that occurs after surgical intervention for retinal detachment.The scarring is a consequence of the surgical procedure itself, and not another unrelated condition. This code is specifically for chorioretinal scars that are a direct result of the retinal detachment surgery.

Example 1: A 60-year-old patient undergoes vitrectomy and scleral buckling for rhegmatogenous retinal detachment. Post-operative examination reveals chorioretinal scarring consistent with H59.81., A 45-year-old patient presents with chorioretinal scarring after pneumatic retinopexy for retinal detachment. The scarring is documented as a complication of the procedure., A 70-year-old patient has undergone multiple surgeries for recurrent retinal detachment.Post-operative examination reveals significant chorioretinal scarring, coded as H59.81, impacting visual acuity.

Complete ophthalmologic examination report including pre-operative and post-operative findings, surgical notes detailing the procedure performed (e.g., vitrectomy, scleral buckling, pneumatic retinopexy), and imaging studies (e.g., fundus photography, OCT) demonstrating the chorioretinal scarring.

** This code should not be used if the chorioretinal scarring is due to a condition other than the retinal detachment surgery.Always consider the underlying cause and document it appropriately.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.