H02.049
BillableSpastic entropion of unspecified eye, unspecified eyelid
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H02.049 an HCC code?
No. H02.049 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
H02.049 is the ICD-10-CM diagnosis code for spastic entropion of unspecified eye, unspecified eyelid. The eyelid turns inward involuntarily due to muscle spasms, affecting an unspecified eye and eyelid location. H02.049 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).
H02.049 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.
This is an unspecified code; use more specific codes (H02.041-H02.048) if the eye and eyelid location are documented.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.049 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.