ICD-10 Code H35.16 – Retinopathy of prematurity, stage 5 (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code H35.16 – Retinopathy of prematurity, stage 5
What it is
H35.16 identifies retinopathy of prematurity at stage 5, the most advanced stage of this retinal disorder in premature infants. It indicates total retinal detachment related to severe disease.
Clinical signs
Clinical features may include severe abnormal retinal vascular development and findings consistent with advanced retinal detachment. Clinical features vary; refer to documentation.
When to use this code
Use this code when the provider documents retinopathy of prematurity, stage 5, or equivalent wording such as advanced ROP with total detachment. Apply it only when the stage is clearly specified in the record. If the stage is unclear, check documentation.
Do not use for
Do not use this code for earlier stages of retinopathy of prematurity or for nonspecific prematurity-related eye disease. Do not assign it when the chart only notes suspected ROP without stage confirmation.
Coding tip
Code the highest documented stage exactly as stated, and verify laterality or additional eye details only if the record supports them.