H02.511
BillableAbnormal innervation syndrome right upper eyelid
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H02.511 an HCC code?
No. H02.511 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
H02.511 is the ICD-10-CM diagnosis code for abnormal innervation syndrome right upper eyelid. A condition affecting the right upper eyelid where the nerve signals controlling the eyelid are abnormal, causing involuntary movements or unusual eyelid behavior. H02.511 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).
H02.511 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 abnormal nerve function; document specific symptoms such as eyelid spasms, synkinesis, or aberrant regeneration.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.511 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code indicates abnormal nerve function; document specific symptoms such as eyelid spasms, synkinesis, or aberrant regeneration
- •Often associated with facial nerve recovery or regeneration; review for related facial nerve conditions