H02.115
BillableCicatricial ectropion of left lower eyelid
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H02.115 an HCC code?
No. H02.115 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
H02.115 is the ICD-10-CM diagnosis code for cicatricial ectropion of left lower eyelid. This condition occurs when scar tissue on the left lower eyelid causes it to turn outward, away from the eye. This can lead to eye irritation, dryness, and exposure of the inner eyelid surface. H02.115 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).
H02.115 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 is documented as left lower eyelid; if bilateral, code both sides separately with appropriate laterality indicators.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.115 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify laterality is documented as left lower eyelid; if bilateral, code both sides separately with appropriate laterality indicators
- •Cicatricial ectropion is typically caused by previous trauma, surgery, or burns; review medical record for underlying etiology that may require additional coding