H02.21B
BillableCicatricial lagophthalmos left 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 H02.21B an HCC code?
No. H02.21B 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
H02.21B is the ICD-10-CM diagnosis code for cicatricial lagophthalmos left eye, upper and lower eyelids. Scarring of the left eye affecting both the upper and lower eyelids, causing inability to close the eye completely. H02.21B 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).
H02.21B 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 on the left eye.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.21B 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 on the left eye
- •Ensure documentation confirms both eyelids are affected before assigning this code