H30.042: Focal chorioretin inflam, macular or paramacular, left eye
Focal chorioretinal inflammation, macular or paramacular, left eye
Quick Clinical & Billing Summary
What is ICD-10-CM code H30.042? H30.042 represents Focal chorioretin inflam, macular or paramacular, left eye. Under official CDC guidelines, this code is billable and specific for claim submission.
Code Hierarchy & Classification
Clinical Guidance & Documentation Standards
Associated Procedures & Medicare RVU Reimbursement
Open RVU Calculator →Typical outpatient and office evaluation procedures frequently billed alongside diagnosis H30.042:
| CPT/HCPCS | Description | Work RVU | Non-Facility Fee | Facility Fee |
|---|---|---|---|---|
| 99213 | Office/outpatient visit, established patient, 20-29 minutes (Low MDM) | 1.30 | $91.69 | $66.79 |
| 99214 | Office/outpatient visit, established patient, 30-39 minutes (Moderate MDM) | 1.92 | $133.61 | $100.21 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection (subcutaneous/intramuscular) | 0.17 | $18.34 | $12.44 |
CPT Modifier & Billing Rules
Append when a significant, separately identifiable evaluation and management service is provided on the same calendar day as a minor surgical procedure or injection.
Identifies procedures or services not normally reported together but distinct under the clinical circumstances. Use CMS X-modifiers (XE, XS, XP, XU) where required by Medicare.
Frequently Asked Questions about H30.042
Is H30.042 a billable ICD-10 code?
Yes, H30.042 is a valid, billable and specific ICD-10-CM code. It can be reported as a primary or secondary diagnosis on medical claims.
What is the ICD-10 code for Focal chorioretin inflam, macular or paramacular, left eye?
The primary ICD-10-CM code for Focal chorioretin inflam, macular or paramacular, left eye is H30.042.
What is the effective date of the current H30.042 code?
The code is active for fiscal year FY2027, effective starting 2026-10-01.
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