H02.235 ICD-10-CM Code: Paralytic lagophthalmos left lower eyelid
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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of eyelid, lacrimal system and orbit (H00-H05)
H02.235
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceParalytic lagophthalmos left lower eyelid
Weakness or paralysis of the left lower eyelid that prevents normal eyelid function, typically from facial nerve involvement.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
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Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for H02.235 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H02.235 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H02.235 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H02.235 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H02.235 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H02.235 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H02.235 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is H02.235 an HCC code?
No. H02.235 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
H02.235 is the ICD-10-CM diagnosis code for paralytic lagophthalmos left lower eyelid. Weakness or paralysis of the left lower eyelid that prevents normal eyelid function, typically from facial nerve involvement. H02.235 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).
H02.235 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.
Distinguish between upper and lower eyelid involvement as codes differ.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.235 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Distinguish between upper and lower eyelid involvement as codes differ
- •Document whether this is acute onset or chronic condition