H02.125
BillableMechanical 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 H02.125 an HCC code?
No. H02.125 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
H02.125 is the ICD-10-CM diagnosis code for mechanical ectropion of left lower eyelid. The lower eyelid of the left eye is turning outward due to mechanical causes, pulling the lid margin away from the eye surface. H02.125 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).
H02.125 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.
Ensure documentation specifies 'mechanical' ectropion rather than other types (senile, spastic, paralytic).
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.125 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation specifies 'mechanical' ectropion rather than other types (senile, spastic, paralytic)
- •Review operative reports if the condition resulted from recent eyelid surgery