ICD-10 Code H31.013 – Macula scars of posterior pole (postinflammatory) (post-traumatic), bilateral (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code H31.013 – Macula scars of posterior pole (postinflammatory) (post-traumatic), bilateral
What it is
This code identifies scarring at the posterior pole of both eyes, involving the macula area. The scars are described as postinflammatory or post-traumatic, meaning they followed inflammation or injury.
Clinical signs
Clinical features vary; refer to documentation. Commonly, bilateral macular scarring is associated with reduced central vision, distortion, or a visible scar on retinal examination.
When to use this code
Use this code when the record documents bilateral macular scars at the posterior pole and links them to prior inflammation or trauma. Apply it when the diagnosis is specific to both eyes and not better described by another retinal disorder. Check documentation if the cause or laterality is unclear.
Do not use for
Do not use this code for unilateral macular scarring, nonspecific retinal scars, or active inflammation without documented scarring. Do not assign it if the chart does not support postinflammatory or post-traumatic origin.
Coding tip
Confirm both laterality and the documented cause before coding, because H31.013 is specific to bilateral posterior pole macular scars.