H35.3230: Exudative age-related macular degeneration, bilateral, stage unspecified
H35.3230, exudative age-related macular degeneration, bilateral, stage unspecified, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 26 HCPCS Level II codes, including J3590 (Unclassified biologics), C9257 (Injection, bevacizumab, 0.25 mg), J2777 (Injection, faricimab-svoa, 0.1 mg). The articles come from 2 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with H35.3230 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J3590 | Unclassified biologics | Carrier judgment | — | 2 |
| C9257 | Injection, bevacizumab, 0.25 mg | Special coverage instructions apply | — | 2 |
| J2777 | Injection, faricimab-svoa, 0.1 mg | Carrier judgment | — | 1 |
| J0178 | Injection, aflibercept, 1 mg | Carrier judgment | — | 1 |
| J0177 | Injection, aflibercept hd, 1 mg | Carrier judgment | — | 1 |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | Carrier judgment | — | 1 |
| J2778 | Injection, ranibizumab, 0.1 mg | Carrier judgment | — | 1 |
| J3490 | Unclassified drugs | Special coverage instructions apply | — | 1 |
| Q5124 | Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg | Carrier judgment | — | 1 |
| J0179 | Injection, brolucizumab-dbll, 1 mg | Carrier judgment | — | 1 |
| J2779 | Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg | Carrier judgment | — | 1 |
| C9399 | Unclassified drugs or biologicals | Special coverage instructions apply | — | 1 |
| Q5147 | Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5149 | Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5150 | Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5153 | Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5155 | Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5168 | Injection, ranibizumab-leyk (nufymco), biosimilar, 0.1 mg | Carrier judgment | — | 1 |
| Q5170 | Injection, aflibercept-boav (eydenzelt), biosimilar, 1 mg | Carrier judgment | — | 1 |
| J7999 | Compounded drug, not otherwise classified | Special coverage instructions apply | — | 1 |
| Q5129 | Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg | Carrier judgment | — | 1 |
| Q5126 | Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg | Carrier judgment | — | 1 |
| Q5118 | Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg | Carrier judgment | — | 1 |
| Q5107 | Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg | Special coverage instructions apply | — | 1 |
| J9035 | Injection, bevacizumab, 10 mg | Carrier judgment | — | 1 |
1 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing H35.3230
- A52451: Billing and Coding: Ranibizumab, Aflibercept and biosimilars (Wellpoint Federal (MAC - Part A, MAC - Part B); 18 Level II codes)
- A53008: Billing and Coding: Intraocular Bevacizumab (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 2 Level II codes)
- A52370: Billing and Coding: Bevacizumab and biosimilars (Wellpoint Federal (MAC - Part A, MAC - Part B); 8 Level II codes)
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other H35 diagnoses (Other retinal disorders)
- H35.3231 — Exudative age-related macular degeneration, bilateral, with active…
- H35.3232 — Exudative age-related macular degeneration, bilateral, with inactive…
- H35.3233 — Exudative age-related macular degeneration, bilateral, with inactive…
- H35.3210 — Exudative age-related macular degeneration, right eye, stage…
- H35.3211 — Exudative age-related macular degeneration, right eye, with active…
- H35.3212 — Exudative age-related macular degeneration, right eye, with inactive…
- H35.3213 — Exudative age-related macular degeneration, right eye, with inactive…
- H35.3220 — Exudative age-related macular degeneration, left eye, stage…
- H35.3221 — Exudative age-related macular degeneration, left eye, with active…
- H35.3222 — Exudative age-related macular degeneration, left eye, with inactive…
- H35.3223 — Exudative age-related macular degeneration, left eye, with inactive…
- H35.351 — Cystoid macular degeneration, right eye
- H35.352 — Cystoid macular degeneration, left eye
- H35.353 — Cystoid macular degeneration, bilateral
- H35.051 — Retinal neovascularization, unspecified, right eye
- H35.052 — Retinal neovascularization, unspecified, left eye
- H35.053 — Retinal neovascularization, unspecified, bilateral
- H35.81 — Retinal edema
Frequently asked questions
Does Medicare cover H35.3230 (Exudative age-related macular degeneration, bilateral…)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list H35.3230 as a covered diagnosis for 26 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 H35.3230?
The Level II codes from the policies most specific to this diagnosis are J3590 (Unclassified biologics, 2 articles); C9257 (Injection, bevacizumab, 0.25 mg, 2 articles); J2777 (Injection, faricimab-svoa, 0.1 mg, 1 article); J0178 (Injection, aflibercept, 1 mg, 1 article); J0177 (Injection, aflibercept hd, 1 mg, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list H35.3230?
A52451 (Billing and Coding: Ranibizumab, Aflibercept and biosimilars); A53008 (Billing and Coding: Intraocular Bevacizumab); A52370 (Billing and Coding: Bevacizumab and biosimilars).
What is ICD-10-CM code H35.3230?
H35.3230 is the ICD-10-CM code for exudative age-related macular degeneration, bilateral, stage unspecified, in category H35 (Other retinal disorders), chapter 7: Diseases of the eye and adnexa.
Next steps
- Run a reimbursement report for a device billed under J3590
- Watch J3590 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J3590
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 7: Diseases of the eye and adnexa · All diagnoses · HCPCS lookup