ICD-10 Code H35.163 – Retinopathy of prematurity, stage 5, bilateral (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code H35.163 – Retinopathy of prematurity, stage 5, bilateral
What it is
H35.163 identifies retinopathy of prematurity at stage 5 in both eyes. This means severe retinal disease in a premature infant, with advanced tractional retinal detachment documented bilaterally.
Clinical signs
Clinical features vary; refer to documentation. Standard references describe stage 5 as total retinal detachment, often with marked visual impairment and advanced retinopathy findings in both eyes.
When to use this code
Use H35.163 when the record clearly states retinopathy of prematurity, stage 5, affecting both eyes. Apply it from ophthalmology, neonatal, or discharge documentation that confirms bilateral stage 5 disease. If laterality or stage is not explicit, check documentation before coding.
Do not use for
Do not use this code for earlier stages of retinopathy of prematurity or for unilateral disease. If the chart only says “ROP” without stage 5 and bilateral confirmation, check documentation.
Coding tip
Code the exact stage and laterality from the provider’s final assessment, not from assumptions based on prematurity alone.