H36.811 Nonproliferative sickle-cell retinopathy, right eye

Billable ICD-10-CM code, FY2026.

Applies from H36 Retinal disorders in diseases classified elsewhere

Excludes1 (never code together)

• 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.-)

Risk adjustment (HCC)

• CMS-HCC V28: HCC 108 — Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major
• CMS-HCC V22: HCC 46 — Severe Hematological Disorders
• ESRD V24: HCC 46

MS-DRG index

Defines the logic of DRG(s) 124-125 in MDC 02.

Medicare Code Edits (MCE v43.1 (April 2026))

• Unacceptable principal diagnosis: These codes describe a circumstance which influences care but is not a current illness or injury, or capture only an underlying condition, and are unacceptable as principal diagnosis.

Nearby codes

• H36 Retinal disorders in diseases classified elsewhere
• H36.8 Other retinal disorders in diseases classified elsewhere
• H36.81 Nonproliferative sickle-cell retinopathy
• H36.811 Nonproliferative sickle-cell retinopathy, right eye (this code)
• H36.812 Nonproliferative sickle-cell retinopathy, left eye
• H36.813 Nonproliferative sickle-cell retinopathy, bilateral
• H36.819 Nonproliferative sickle-cell retinopathy, unspecified eye
• H36.82 Proliferative sickle-cell retinopathy
• H36.821 Proliferative sickle-cell retinopathy, right eye