A51.43 ICD-10-CM Code: Secondary syphilitic oculopathy
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Infections with a predominantly sexual mode of transmission (A50-A64)
A51.43
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceSecondary syphilitic oculopathy
This is an eye infection or inflammation caused by secondary syphilis, which occurs in the second stage of untreated syphilis infection. The condition affects the eyes and vision and develops weeks to months after the initial syphilis infection.
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
Official- Secondary syphilitic chorioretinitis
- Secondary syphilitic iridocyclitis, iritis
- Secondary syphilitic uveitis
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for A51.43 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for A51.43 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for A51.43 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for A51.43 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for A51.43 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for A51.43 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 A51.43 an HCC code?
No. A51.43 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
A51.43 is the ICD-10-CM diagnosis code for secondary syphilitic oculopathy. This is an eye infection or inflammation caused by secondary syphilis, which occurs in the second stage of untreated syphilis infection. The condition affects the eyes and vision and develops weeks to months after the initial syphilis infection. A51.43 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering infections with a predominantly sexual mode of transmission (a50-a64).
A51.43 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 should only be used when syphilis has progressed to the secondary stage with documented eye involvement; verify that the patient has confirmed secondary syphilis diagnosis.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A51.43 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code should only be used when syphilis has progressed to the secondary stage with documented eye involvement; verify that the patient has confirmed secondary syphilis diagnosis
- •This code is part of a combination concept and should not be used with a separate code for secondary syphilis (A51.-); ensure documentation specifies the ocular manifestation to support medical necessity