H02.209
BillableUnspecified lagophthalmos unspecified eye, unspecified eyelid
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H02.209 an HCC code?
No. H02.209 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
H02.209 is the ICD-10-CM diagnosis code for unspecified lagophthalmos unspecified eye, unspecified eyelid. Inability of an unspecified eye's eyelid to close completely, with neither the eye nor the specific eyelid location specified. H02.209 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).
H02.209 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.
This is the least specific lagophthalmos code; use only when laterality and eyelid location cannot be determined.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.209 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is the least specific lagophthalmos code; use only when laterality and eyelid location cannot be determined
- •Always attempt to obtain clarification from documentation or provider to assign a more specific code