H36.819

Nonproliferative sickle-cell retinopathy, unspecified eye

Risk-adjusting (HCC)Billable code

HCC risk adjustment mapping

CMS-HCC V28

HCC108

Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major

CMS-HCC ESRD V24

HCC46

Severe Hematological Disorders

Coding notes

Excludes 1 never coded together · Excludes 2 may co-exist

Inherited from H36Retinal disorders in diseases classified elsewhere
Excludes 1

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

Code first

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

Inherited from chapter 7Diseases of the eye and adnexa
Excludes 2

certain conditions originating in the perinatal period (P04-P96) certain infectious and parasitic diseases (A00-B99) complications of pregnancy, childbirth and the puerperium (O00-O9A) congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99) diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-) endocrine, nutritional and metabolic diseases (E00-E88) injury (trauma) of eye and orbit (S05.-) injury, poisoning and certain other consequences of external causes (S00-T88) neoplasms (C00-D49) symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94) syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)

Note

Use an external cause code following the code for the eye condition, if applicable, to identify the cause of the eye condition

Official Guidelines for H36.819

FY 2026 ›