H36.819
Nonproliferative sickle-cell retinopathy, unspecified eye
H36.819 (also written H36819) is a billable ICD-10-CM diagnosis code for nonproliferative sickle-cell retinopathy, unspecified eye. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 9 codes in category H36 (Retinal disorders in diseases classified elsewhere). Its coding notes include a Code first instruction, 2 Excludes1 entries and 11 Excludes2 entries.
Code first
If the underlying condition listed here is present and known, sequence it first.
Excludes1
Not coded here. The listed conditions generally should not be reported together.
Excludes2
Not included here. Both codes may be reported if the patient has both conditions.
Also from chapter/block level (11 notes)
- 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)
Care settings
How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.
Hospice: not accepted as primary
Not accepted as the principal diagnosis on a hospice claim (bill types 081x and 082x). The Integrated OCE returns an edit for this code.
Reason: Supplementary or additional code, not allowed as principal diagnosis.
Notes
Also from chapter/block level (1 note)
- Use an external cause code following the code for the eye condition, if applicable, to identify the cause of the eye condition