ICD-10 Code H35.113 – Retinopathy of prematurity, stage 0, bilateral (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code H35.113 – Retinopathy of prematurity, stage 0, bilateral
What it is
This code identifies bilateral retinopathy of prematurity at stage 0, meaning an infant at risk for ROP but without visible retinal abnormality. Use it when the record documents prematurity-related eye screening with no stage changes.
Clinical signs
Clinical features vary; refer to documentation. Stage 0 indicates no active ROP findings on exam, while bilateral specifies both eyes are involved in the screening diagnosis.
When to use this code
Use this code when the ophthalmology note states stage 0 ROP in both eyes, such as after a premature infant screening exam. It is appropriate for follow-up documentation when no retinal lesions are seen but ROP surveillance continues.
Do not use for
Do not use it for higher-stage ROP, unilateral disease, or nonspecific prematurity without documented retinal screening findings. Check documentation if the note does not clearly state stage 0 and bilateral involvement.
Coding tip
Confirm both the stage and laterality in the eye exam note before assigning H35.113.