A18.54 ICD-10-CM Code: Tuberculous iridocyclitis
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Tuberculosis (A15-A19)
A18.54
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceTuberculous iridocyclitis
This is an infection of the eye caused by tuberculosis bacteria, specifically affecting the iris and ciliary body (the parts of the eye that control light and focus). It can cause eye inflammation, pain, and vision problems if left untreated.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for A18.54 in this effective period.
Excludes 2
Official- lupus vulgaris of eyelid (A18.4)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for A18.54 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for A18.54 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for A18.54 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for A18.54 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for A18.54 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is A18.54 an HCC code?
No. A18.54 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
A18.54 is the ICD-10-CM diagnosis code for tuberculous iridocyclitis. This is an infection of the eye caused by tuberculosis bacteria, specifically affecting the iris and ciliary body (the parts of the eye that control light and focus). It can cause eye inflammation, pain, and vision problems if left untreated. A18.54 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering tuberculosis (a15-a19).
A18.54 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
This code requires documentation confirming tuberculosis as the cause of the iridocyclitis; do not assign if the iridocyclitis is from another cause.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A18.54 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code requires documentation confirming tuberculosis as the cause of the iridocyclitis; do not assign if the iridocyclitis is from another cause
- •Verify that the patient has confirmed TB disease (not just TB exposure or latent TB) and that the eye involvement is specifically documented as tuberculous in origin