H02.20A
BillableUnspecified lagophthalmos right eye, upper and lower eyelids
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H02.20A an HCC code?
No. H02.20A 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
H02.20A is the ICD-10-CM diagnosis code for unspecified lagophthalmos right eye, upper and lower eyelids. Inability of both the upper and lower eyelids of the right eye to close completely. H02.20A 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).
H02.20A 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 code indicates bilateral eyelid involvement (both upper and lower) of the right eye; ensure documentation supports this finding.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.20A sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code indicates bilateral eyelid involvement (both upper and lower) of the right eye; ensure documentation supports this finding
- •When both eyelids are affected, this code is more appropriate than coding upper and lower separately