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H02.121

Billable

Mechanical 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 H02.121 an HCC code?

No. H02.121 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

H02.121 is the ICD-10-CM diagnosis code for mechanical ectropion of right upper eyelid. The upper eyelid on the right side is turning outward away from the eye due to mechanical causes such as weakness, laxity, or loss of tone. H02.121 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).

H02.121 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.

Mechanical ectropion differs from cicatricial; it results from tissue laxity rather than scarring.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.121 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Mechanical ectropion differs from cicatricial; it results from tissue laxity rather than scarring
  • Document any associated conditions like facial nerve palsy or age-related changes

Code Hierarchy

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