H02.203
BillableUnspecified lagophthalmos right eye, unspecified eyelid
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H02.203 an HCC code?
No. H02.203 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
H02.203 is the ICD-10-CM diagnosis code for unspecified lagophthalmos right eye, unspecified eyelid. Inability of the right eye's eyelid to close completely, with the specific eyelid (upper or lower) not specified. H02.203 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).
H02.203 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.
Use this code only when documentation does not specify whether the upper or lower eyelid is affected.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.203 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.