H35.4
Non-Billable

Peripheral retinal degeneration

Non-Billable / Non-Specific Code

What is Peripheral retinal degeneration?

ICD-10-CM H35.4 is the diagnosis code for Peripheral retinal degeneration. This code falls under the section "Disorders of choroid and retina" within Chapter 7 — Diseases of the eye and adnexa (H00-H59). It is a non-billable/non-specific ICD-10-CM code that should not be used for reimbursement. A more specific sub-code is required for billing. Medical coders and healthcare providers use this code to document and classify diagnoses in electronic health records, insurance claims, and clinical databases.

⛔ Excludes1
â„šī¸ Excludes2

Coding Guidelines for H35.4

⛔ Type 1 Excludes (Never code together)

The following conditions should never be coded at the same time as H35.4. They are mutually exclusive:

  • hereditary retinal degeneration (dystrophy) (H35.5-)

â„šī¸ Type 2 Excludes (Code separately if applicable)

The following conditions are not included in H35.4. If the patient has both, code each condition separately:

  • peripheral retinal degeneration with retinal break (H33.3-)

ICD-10-CM Code Hierarchy

Understanding where H35.4 sits in the ICD-10-CM classification helps ensure proper coding:

Sub-Codes 7 entries
H35.40Unspecified peripheral retinal degenerationBillableH35.41Lattice degeneration of retinaNon-BillableH35.411Lattice degeneration of retina, right eyeBillableH35.412Lattice degeneration of retina, left eyeBillableH35.413Lattice degeneration of retina, bilateralBillableH35.419Lattice degeneration of retina, unspecified eyeBillableH35.42Microcystoid degeneration of retinaNon-BillableH35.421Microcystoid degeneration of retina, right eyeBillableH35.422Microcystoid degeneration of retina, left eyeBillableH35.423Microcystoid degeneration of retina, bilateralBillableH35.429Microcystoid degeneration of retina, unspecified eyeBillableH35.43Paving stone degeneration of retinaNon-BillableH35.431Paving stone degeneration of retina, right eyeBillableH35.432Paving stone degeneration of retina, left eyeBillableH35.433Paving stone degeneration of retina, bilateralBillableH35.439Paving stone degeneration of retina, unspecified eyeBillableH35.44Age-related reticular degeneration of retinaNon-BillableH35.441Age-related reticular degeneration of retina, right eyeBillableH35.442Age-related reticular degeneration of retina, left eyeBillableH35.443Age-related reticular degeneration of retina, bilateralBillableH35.449Age-related reticular degeneration of retina, unspecified eyeBillableH35.45Secondary pigmentary degenerationNon-BillableH35.451Secondary pigmentary degeneration, right eyeBillableH35.452Secondary pigmentary degeneration, left eyeBillableH35.453Secondary pigmentary degeneration, bilateralBillableH35.459Secondary pigmentary degeneration, unspecified eyeBillableH35.46Secondary vitreoretinal degenerationNon-BillableH35.461Secondary vitreoretinal degeneration, right eyeBillableH35.462Secondary vitreoretinal degeneration, left eyeBillableH35.463Secondary vitreoretinal degeneration, bilateralBillableH35.469Secondary vitreoretinal degeneration, unspecified eyeBillable
Related Codes

Frequently Asked Questions

Is H35.4 a billable ICD-10-CM code?

No, H35.4 is a non-billable/non-specific code. You should use a more specific sub-code for billing and reimbursement.

What does H35.4 mean?

H35.4 is the ICD-10-CM diagnosis code for "Peripheral retinal degeneration". It is used by healthcare providers to classify and document this condition in medical records and insurance claims.

What is the parent code of H35.4?

The parent code of H35.4 is H35 ("Other retinal disorders"). H35.4 provides a more specific classification within this category.

What section is H35.4 in?

H35.4 is located in Section H30-H36 — "Disorders of choroid and retina" within Chapter 7 of the ICD-10-CM Tabular List.

What are the sub-codes of H35.4?

H35.4 has 7 sub-code(s) that provide more specific detail: H35.40, H35.41, H35.42, H35.43, H35.44 and more.

When should I use H35.4?

Use H35.4 when the patients documented diagnosis matches "Peripheral retinal degeneration" and the clinical documentation supports this level of specificity. Always verify with the latest ICD-10-CM guidelines and payer requirements.

People Also Ask

What is the ICD-10 code for Peripheral retinal degeneration?

The ICD-10-CM code for Peripheral retinal degeneration is H35.4.

Can H35.4 be used for primary diagnosis?

No, H35.4 is non-billable. Use a more specific sub-code for primary diagnosis billing.

What chapter is H35.4 in?

H35.4 is in Chapter 7 of the ICD-10-CM Tabular List.

What conditions are excluded from H35.4?

Type 1 Excludes for H35.4 include: hereditary retinal degeneration (dystrophy) (H35.5-).

Is H35.4 valid for 2026?

Yes, H35.4 is a valid ICD-10-CM code for the 2026 fiscal year, subject to official CMS updates.

See Also

← PreviousH35.389Toxic maculopathy, unspecified eyeNext →H35.40Unspecified peripheral retinal degeneration
Code Details
H35.4
Peripheral retinal degeneration
Non-Billable / Non-Specific Code
7 — Diseases of the eye and adnexa (H00-H59)
H30-H36 — Disorders of choroid and retina
2026 ICD-10-CM