H02.106
BillableUnspecified ectropion of left eye, unspecified eyelid
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H02.106 an HCC code?
No. H02.106 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
H02.106 is the ICD-10-CM diagnosis code for unspecified ectropion of left eye, unspecified eyelid. Ectropion is a condition where the lower eyelid turns outward and away from the eye, causing the inner surface of the eyelid to be exposed. This code specifically refers to this condition affecting the left eye when the specific eyelid location is not documented. H02.106 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).
H02.106 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 documentation to determine if a more specific eyelid location (upper, lower, or both) can be identified, as this would allow for a more precise code assignment.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.106 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation to determine if a more specific eyelid location (upper, lower, or both) can be identified, as this would allow for a more precise code assignment
- •Confirm laterality is documented as left eye; if bilateral or right eye involvement exists, use the appropriate laterality code (H02.105 for right eye or H02.10 for bilateral)