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v1.0.0
ICD-10 Guide
DiagnosesFamilial Drusen

Familial Drusen

ICD-10 Coding for Familial Drusen(H35.5, H35.363)

PRIMARY SPECIALTYOphthalmology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Familial Drusen?
Essential facts and insights about Familial Drusen

Key Clinical Considerations:

  • Presence of yellow-white deposits (drusen) in the retina
  • Visual disturbances or loss of vision
  • Family history of drusen or related retinal conditions

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history including family history of ocular conditions
  • Detailed description of drusen characteristics and location
  • Results from fundus examination and imaging studies

Coding Guidelines

Usage Guidelines & Examples

  • Usage guidelines: Use H35.32 for familial drusen specifically.
  • Common errors: Confusing familial drusen with age-related macular degeneration.

Code Exclusions

Important Exclusions

  • Excluded conditions: Non-familial drusen, age-related macular degeneration.
  • Alternative codes: H35.30 (Drusen, unspecified) may be used for non-familial cases.

Related ICD-10 Codes

Primary Codes
H35.32
Familial drusen
Ancillary Codes
H35.363
Differential Codes
H35.30
H35.5
for hereditary conditions;
H35.30
is for unspecified or age-related cases.
H35.32-

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Ophthalmology

Specialty Applications

  • Patient populations: Individuals with a family history of drusen.
  • Clinical settings: Ophthalmology clinics and retina specialty practices.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

Documentation requirements?

Document family history, clinical findings, and imaging results.

Billing considerations?

Ensure accurate coding to reflect familial nature and associated symptoms.