H02.101
BillableUnspecified ectropion of right upper eyelid
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H02.101 an HCC code?
No. H02.101 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
H02.101 is the ICD-10-CM diagnosis code for unspecified ectropion of right upper eyelid. The right upper eyelid turns outward away from the eye, but the underlying cause is not specified. H02.101 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).
H02.101 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.
Ectropion can be caused by various factors (paralysis, scarring, age-related); if the cause is documented, use a more specific code.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.101 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ectropion can be caused by various factors (paralysis, scarring, age-related); if the cause is documented, use a more specific code
- •Distinguish between mechanical, paralytic, and senile ectropion when documentation permits