H02.025 ICD-10-CM Code: Mechanical entropion of 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)
H02.025
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceMechanical entropion of left lower eyelid
The lower eyelid of the left eye is turning inward due to mechanical causes, such as muscle weakness or laxity.
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
OfficialICD-10-CM does not list inclusion terms for H02.025 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H02.025 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H02.025 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H02.025 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H02.025 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H02.025 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H02.025 in this effective period.
Buddy Documentation Tip
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 H02.025 an HCC code?
No. H02.025 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- H02.025
- Description
- Mechanical entropion of 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
H02.025 is the ICD-10-CM diagnosis code for mechanical entropion of left lower eyelid. The lower eyelid of the left eye is turning inward due to mechanical causes, such as muscle weakness or laxity. H02.025 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).
H02.025 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.
Verify laterality and eyelid location in the medical record to ensure accurate code selection.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.025 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify laterality and eyelid location in the medical record to ensure accurate code selection.
- •Document any associated symptoms such as eye irritation, tearing, or vision problems.