What is ICD-10 code H01.129?

H01.129 is the ICD-10-CM diagnosis code for Discoid lupus erythematosus of unspecified eye, unspecified eyelid. A chronic autoimmune skin condition from discoid lupus erythematosus affecting the eyelid, but neither the specific eye nor the specific eyelid location is documented. H01.129 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. H01.129 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. H01.129 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. H01.129 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does H01.129 map to under V28?

H01.129 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

What RAF reference is published for H01.129?

H01.129 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

What is the V28 vs V24 difference for H01.129?

H01.129 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

What documentation supports H01.129?

This is the least specific code in the DLE eyelid series; use only when laterality and eyelid location are completely undocumented Attempt to obtain clarification from clinical documentation before defaulting to this unspecified code H01.129 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

2026 ICD-10-CM H01.129: Discoid lupus erythematosus

H01.129 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools

ICD-10-CM Code View

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Code lookupH01.129

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of eyelid, lacrimal system and orbit (H00-H05)

H01.129

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Discoid lupus erythematosus of unspecified eye, unspecified eyelid

A chronic autoimmune skin condition from discoid lupus erythematosus affecting the eyelid, but neither the specific eye nor the specific eyelid location is documented.

Buddy Insight

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

Mapped

HCC 317

Discoid Lupus Erythematosus

Code-level coefficient reference

Code Book Path

Official

H01.1Noninfectious dermatoses of eyelid H01.12Discoid lupus erythematosus of eyelid H01.129Discoid lupus erythematosus of unspecified eye, unspecified eyelid

Inclusion Terms

Official

No inclusion terms are included in this display for H01.129. Check the code and parent instructions in the Code Book.

Excludes 2

Official

certain conditions originating in the perinatal period (P04-P96)Inherited from H00-H59, H00-H05
certain infectious and parasitic diseases (A00-B99)Inherited from H00-H59, H00-H05
complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from H00-H59, H00-H05
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from H00-H59, H00-H05
diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)Inherited from H00-H59, H00-H05
endocrine, nutritional and metabolic diseases (E00-E88)Inherited from H00-H59, H00-H05
injury (trauma) of eye and orbit (S05.-)Inherited from H00-H59, H00-H05
injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from H00-H59, H00-H05
neoplasms (C00-D49)Inherited from H00-H59, H00-H05
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from H00-H59, H00-H05
syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)Inherited from H00-H59, H00-H05
open wound of eyelid (S01.1-)Inherited from H00-H59, H00-H05
superficial injury of eyelid (S00.1-, S00.2-)Inherited from H00-H59, H00-H05

Related Codes

Official

H01.121Discoid lupus erythematosus of right upper eyelid H01.122Discoid lupus erythematosus of right lower eyelid H01.123Discoid lupus erythematosus of right eye, unspecified eyelid H01.124Discoid lupus erythematosus of left upper eyelid H01.125Discoid lupus erythematosus of left lower eyelid

Includes

Official

No Includes notes are included in this display for H01.129. Check the code and parent instructions in the Code Book.

Excludes 1

Official

No Excludes 1 notes are included in this display for H01.129. Check the code and parent instructions in the Code Book.

Code First

Official

No Code First sequencing instructions are included in this display for H01.129. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for H01.129. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for H01.129. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of discoid lupus erythematosus affecting the eyelid(s)

Clinical or biopsy confirmation of the discoid lupus diagnosis

Assessment of bilateral versus unilateral involvement

Documentation of treatment plan

MEAT Support

HCC Buddy guidance

Documentation of discoid lupus erythematosus affecting the eyelid(s)

Clinical or biopsy confirmation of the discoid lupus diagnosis

Assessment of bilateral versus unilateral involvement

Documentation of treatment plan

Audit Caution

HCC Buddy guidance

Using this fully unspecified code when any laterality or eyelid information exists in the medical record

Not reviewing ophthalmology or dermatology notes that may contain the specific laterality and eyelid details

Failing to query the provider for laterality, which is almost always determinable on examination

Using this code simply for convenience rather than thoroughly reviewing documentation for specificity

Common Mistakes

HCC Buddy guidance

H01.121-H01.126 — Specific laterality and eyelid codes: use any of these when more specific information is available

L93.0 — Discoid lupus erythematosus (skin): general cutaneous code without eyelid specificity

H01.009 — Unspecified blepharitis, unspecified eye: non-lupus eyelid inflammation

M32.9 — Systemic lupus erythematosus, unspecified: systemic form, not limited to cutaneous/eyelid

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is H01.129 an HCC code?

H01.129 is not in the CMS-HCC V28 or V24 community payment model. H01.129 has a separate mapping under the Part D RxHCC model (HCC 317 (Discoid Lupus Erythematosus)); the applicable result needs member context.

Code: H01.129
Description: Discoid lupus erythematosus of unspecified eye, unspecified eyelid
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

RxHCCHCC 317, Discoid Lupus Erythematosus

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work H01.129 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for H01.129

For H01.129, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Coder workflow notes

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What This Code Means

H01.129 is the ICD-10-CM diagnosis code for discoid lupus erythematosus of unspecified eye, unspecified eyelid. A chronic autoimmune skin condition from discoid lupus erythematosus affecting the eyelid, but neither the specific eye nor the specific eyelid location is documented. H01.129 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).

H01.129 has no mapping under the CMS-HCC V28 or V24 community payment models. H01.129 has a separate mapping under the Part D RxHCC model (HCC 317 (Discoid Lupus Erythematosus)); the applicable result needs member context. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.

This is the least specific code in the DLE eyelid series; use only when laterality and eyelid location are completely undocumented.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for H01.129 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This is the least specific code in the DLE eyelid series; use only when laterality and eyelid location are completely undocumented
•Attempt to obtain clarification from clinical documentation before defaulting to this unspecified code

Clinical Significance

Discoid lupus erythematosus of unspecified eye, unspecified eyelid is the least specific code in the eyelid discoid lupus series, used when neither the laterality nor the specific eyelid is documented. This code should be used only as a last resort when clinical documentation cannot support any laterality or eyelid specificity. It represents a significant documentation improvement opportunity.

Documentation Requirements

✓Documentation of discoid lupus erythematosus affecting the eyelid(s)
✓Clinical or biopsy confirmation of the discoid lupus diagnosis
✓Assessment of bilateral versus unilateral involvement
✓Documentation of treatment plan
✓Notation that laterality and specific eyelid could not be determined from available information

Commonly Confused Codes

•H01.121-H01.126: Specific laterality and eyelid codes: use any of these when more specific information is available
•L93.0: Discoid lupus erythematosus (skin): general cutaneous code without eyelid specificity
•H01.009: Unspecified blepharitis, unspecified eye: non-lupus eyelid inflammation
•M32.9: Systemic lupus erythematosus, unspecified: systemic form, not limited to cutaneous/eyelid