ICD-10 · PDGM grouping
H36 Retinal disorders in diseases classified elsewhere
All 9 codes in the H36 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
9
Can lead a claim
0
Cannot lead a claim
9
What CMS assigns to H36
None of the 9 codes is assigned a clinical group. None of the 9 is assigned a comorbidity subgroup. None can lead a claim. CMS attaches a code-first note to all 9.
Code first
CMS grouper convention 52, on all 9 codes. Code first:
- lipid storage disorders (E75.-)
- sickle-cell disorders (D57.-)
- underlying disease, such as:
Every code in H36
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| H36.8 Other retinal disorders in diseases classified elsewhere | ||||
| H36.81 Nonproliferative sickle-cell retinopathy | ||||
| H36.811 | Nonproliferative sickle-cell retinopathy, right eye | Cannot lead a claimUnacceptable principal diagnosis, code is not reportable as principal diagnosis | None | None |
| H36.812 | Nonproliferative sickle-cell retinopathy, left eye | Cannot lead a claimUnacceptable principal diagnosis, code is not reportable as principal diagnosis | None | None |
| H36.813 | Nonproliferative sickle-cell retinopathy, bilateral | Cannot lead a claimUnacceptable principal diagnosis, code is not reportable as principal diagnosis | None | None |
| H36.819 | Nonproliferative sickle-cell retinopathy, unspecified eye | Cannot lead a claimUnacceptable principal diagnosis, code is not reportable as principal diagnosis | None | None |
| H36.82 Proliferative sickle-cell retinopathy | ||||
| H36.821 | Proliferative sickle-cell retinopathy, right eye | Cannot lead a claimUnacceptable principal diagnosis, code is not reportable as principal diagnosis | None | None |
| H36.822 | Proliferative sickle-cell retinopathy, left eye | Cannot lead a claimUnacceptable principal diagnosis, code is not reportable as principal diagnosis | None | None |
| H36.823 | Proliferative sickle-cell retinopathy, bilateral | Cannot lead a claimUnacceptable principal diagnosis, code is not reportable as principal diagnosis | None | None |
| H36.829 | Proliferative sickle-cell retinopathy, unspecified eye | Cannot lead a claimUnacceptable principal diagnosis, code is not reportable as principal diagnosis | None | None |
| H36.89 | Other retinal disorders in diseases classified elsewhere | Cannot lead a claimManifestation code is not reportable as principal diagnosis | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
The monthly home health regs digest
What CMS changed, what's due next, and what to do about it — one email a month, no fluff. Read the first issue