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.

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

H01.129 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards H01.129 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

What should coders know when reporting 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 ICD-10 Code: Discoid lupus erythematosus

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupH01.129Effective 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

CMS-HCC V28

Not risk-adjusted for this model/period.

RAF 0

CMS-HCC V24

Not risk-adjusted for this model/period.

RAF 0

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Not risk-adjusted for this model/period.

RAF 0

RXHCC

Mapped

HCC 317

Lupus, Cutaneous

RAF 0.0

Code Trumping

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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

ICD-10-CM does not list inclusion terms for H01.129 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H01.129 in this effective period.

Related Child 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

ICD-10-CM does not list Includes notes for H01.129 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for H01.129 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H01.129 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H01.129 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H01.129 in this effective period.

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

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 H01.129 an HCC code?

No. H01.129 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

HCC Category Mapping

RxHCCHCC 317, Lupus, Cutaneous

0.000

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

MEAT Criteria for H01.129

For H01.129to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

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

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed H01.129 during that encounter, not just copy-forwarded from a problem list.

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 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.

In the RxHCC model, H01.129 maps to RxHCC 317 (Lupus, Cutaneous) with a RAF weight of 0.0. No V28, V24, or ESRD HCC mappings exist. The HCC mapping is identical to all other H01.12x codes, so specificity does not change the risk adjustment value. However, unspecified codes face greater audit scrutiny and may indicate documentation quality concerns.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, 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