H02.039 ICD-10-CM Code: Senile entropion of unspecified eye, unspecified 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)
H02.039
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceSenile entropion of unspecified eye, unspecified eyelid
This condition occurs when the eyelid of an unspecified eye turns inward due to age-related weakening of the eyelid muscles and tissues, causing the eyelashes to rub against the eye surface. It can lead to eye irritation, tearing, and discomfort.
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
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Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for H02.039 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H02.039 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H02.039 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H02.039 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H02.039 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H02.039 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H02.039 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 H02.039 an HCC code?
No. H02.039 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
H02.039 is the ICD-10-CM diagnosis code for senile entropion of unspecified eye, unspecified eyelid. This condition occurs when the eyelid of an unspecified eye turns inward due to age-related weakening of the eyelid muscles and tissues, causing the eyelashes to rub against the eye surface. It can lead to eye irritation, tearing, and discomfort. H02.039 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).
H02.039 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 whether the condition affects the right eye, left eye, or both eyes, as more specific codes (H02.031 for right eye, H02.032 for left eye, H02.033 for bilateral) should be used when this information is documented.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.039 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify whether the condition affects the right eye, left eye, or both eyes, as more specific codes (H02.031 for right eye, H02.032 for left eye, H02.033 for bilateral) should be used when this information is documented
- •Confirm the eyelid location (upper or lower) is documented; if specified, use the appropriate fifth character code rather than 'unspecified' to ensure accurate billing and clinical documentation