H02.232
BillableParalytic lagophthalmos right lower eyelid
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H02.232 an HCC code?
No. H02.232 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
H02.232 is the ICD-10-CM diagnosis code for paralytic lagophthalmos right lower eyelid. This condition occurs when the right lower eyelid cannot close properly due to muscle weakness or nerve damage, preventing the eye from being fully covered during blinking or sleep. This can lead to dry eye and potential corneal damage if left untreated. H02.232 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).
H02.232 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.
Verify laterality is documented as right lower eyelid; if bilateral or affecting both upper and lower lids, use different codes (H02.231 for right upper, H02.233 for left upper, H02.234 for left lower).
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.232 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify laterality is documented as right lower eyelid; if bilateral or affecting both upper and lower lids, use different codes (H02.231 for right upper, H02.233 for left upper, H02.234 for left lower)
- •Ensure the paralytic nature is confirmed in documentation; if lagophthalmos is due to other causes (mechanical, cicatricial), different codes apply