H02.202
BillableUnspecified lagophthalmos right lower eyelid
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H02.202 an HCC code?
No. H02.202 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
H02.202 is the ICD-10-CM diagnosis code for unspecified lagophthalmos right lower eyelid. Inability of the right lower eyelid to close completely, which can lead to eye irritation and dryness. H02.202 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).
H02.202 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.
Distinguish between upper and lower eyelid involvement as they have different codes and may require different treatment approaches.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.202 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Distinguish between upper and lower eyelid involvement as they have different codes and may require different treatment approaches
- •Document whether this is mechanical (structural) or neurogenic (nerve-related) lagophthalmos for clinical clarity