H00.025 ICD-10-CM Code: Hordeolum internum left lower eyelid
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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of eyelid, lacrimal system and orbit (H00-H05)
H00.025
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceHordeolum internum left lower eyelid
A painful infection or swelling of the inner eyelid structures on the left lower eyelid, typically involving the meibomian glands.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Infection of meibomian gland
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H00.025 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H00.025 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H00.025 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H00.025 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H00.025 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H00.025 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 H00.025 an HCC code?
No. H00.025 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- H00.025
- Description
- Hordeolum internum left lower eyelid
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
H00.025 is the ICD-10-CM diagnosis code for hordeolum internum left lower eyelid. A painful infection or swelling of the inner eyelid structures on the left lower eyelid, typically involving the meibomian glands. H00.025 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering disorders of eyelid, lacrimal system and orbit (h00-h05).
H00.025 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.
Ensure documentation specifies left eye and lower eyelid location to justify this specific code.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H00.025 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation specifies left eye and lower eyelid location to justify this specific code
- •Lower eyelid involvement may be more noticeable to patients due to increased eyelid movement