What is ICD-10 code H02.126?

H02.126 is the ICD-10-CM diagnosis code for Mechanical ectropion of left eye, unspecified eyelid. It belongs to the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59). H02.126 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. H02.126 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. H02.126 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. H02.126 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does H02.126 map to under V28?

H02.126 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

What RAF reference is published for H02.126?

H02.126 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

What is the V28 vs V24 difference for H02.126?

H02.126 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

2026 ICD-10-CM H02.126: Mechanical ectropion of left eye

H02.126 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools

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Code lookupH02.126

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of eyelid, lacrimal system and orbit (H00-H05)

H02.126

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Mechanical ectropion of left eye, unspecified eyelid

The lower or upper eyelid of the left eye is turning outward away from the eye surface, causing the inner eyelid surface to be exposed. This condition is caused by mechanical factors such as scarring, injury, or loss of skin elasticity rather than muscle weakness.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

H02.1Ectropion of eyelid H02.12Mechanical ectropion of eyelid H02.126Mechanical ectropion of left eye, unspecified eyelid

Inclusion Terms

Official

No inclusion terms are included in this display for H02.126. Check the code and parent instructions in the Code Book.

Excludes 2

Official

certain conditions originating in the perinatal period (P04-P96)Inherited from H00-H59, H00-H05
certain infectious and parasitic diseases (A00-B99)Inherited from H00-H59, H00-H05
complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from H00-H59, H00-H05
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from H00-H59, H00-H05
diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)Inherited from H00-H59, H00-H05
endocrine, nutritional and metabolic diseases (E00-E88)Inherited from H00-H59, H00-H05
injury (trauma) of eye and orbit (S05.-)Inherited from H00-H59, H00-H05
injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from H00-H59, H00-H05
neoplasms (C00-D49)Inherited from H00-H59, H00-H05
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from H00-H59, H00-H05
syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)Inherited from H00-H59, H00-H05
open wound of eyelid (S01.1-)Inherited from H00-H59, H00-H05
superficial injury of eyelid (S00.1-, S00.2-)Inherited from H00-H59, H00-H05

Related Codes

Official

H02.121Mechanical ectropion of right upper eyelid H02.122Mechanical ectropion of right lower eyelid H02.123Mechanical ectropion of right eye, unspecified eyelid H02.124Mechanical ectropion of left upper eyelid H02.125Mechanical ectropion of left lower eyelid

Includes

Official

No Includes notes are included in this display for H02.126. Check the code and parent instructions in the Code Book.

Excludes 1

Official

congenital malformations of eyelid (Q10.0-Q10.3)Inherited from H02

Code First

Official

No Code First sequencing instructions are included in this display for H02.126. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for H02.126. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for H02.126. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Verify whether the ectropion affects the upper eyelid (H02.121), lower eyelid (H02.122), or is unspecified (H02.126) before assigning the code

Document the underlying cause if known (such as post-surgical scarring, trauma, or dermatitis) as this may support medical necessity for treatment and help guide clinical management

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is H02.126 an HCC code?

No. H02.126 is a billable ICD-10-CM code with no mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code: H02.126
Description: Mechanical ectropion of left eye, unspecified eyelid
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

Coder workflow notes

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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

H02.126 is the ICD-10-CM diagnosis code for mechanical ectropion of left eye, unspecified eyelid. The lower or upper eyelid of the left eye is turning outward away from the eye surface, causing the inner eyelid surface to be exposed. This condition is caused by mechanical factors such as scarring, injury, or loss of skin elasticity rather than muscle weakness. H02.126 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).

H02.126 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Verify whether the ectropion affects the upper eyelid (H02.121), lower eyelid (H02.122), or is unspecified (H02.126) before assigning the code.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for H02.126 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify whether the ectropion affects the upper eyelid (H02.121), lower eyelid (H02.122), or is unspecified (H02.126) before assigning the code
•Document the underlying cause if known (such as post-surgical scarring, trauma, or dermatitis) as this may support medical necessity for treatment and help guide clinical management