H02.129
BillableMechanical ectropion of unspecified eye, unspecified eyelid
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H02.129 an HCC code?
No. H02.129 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
H02.129 is the ICD-10-CM diagnosis code for mechanical ectropion of unspecified eye, unspecified eyelid. The eyelid is turning outward away from the eye due to mechanical causes (such as scarring, injury, or muscle weakness), but the specific eye and which eyelid is affected are not documented. This condition can cause eye irritation, tearing, and exposure of the inner eyelid surface. H02.129 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).
H02.129 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.
Query the provider to determine the laterality (right eye, left eye, or bilateral) and which eyelid (upper or lower) is affected, as more specific codes exist and may be required for accurate billing.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.129 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Query the provider to determine the laterality (right eye, left eye, or bilateral) and which eyelid (upper or lower) is affected, as more specific codes exist and may be required for accurate billing
- •Mechanical ectropion differs from other types (paralytic, involutional, cicatricial) - ensure the documentation supports the 'mechanical' classification before coding