H02.512
BillableAbnormal innervation syndrome right lower eyelid
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H02.512 an HCC code?
No. H02.512 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
H02.512 is the ICD-10-CM diagnosis code for abnormal innervation syndrome right lower eyelid. A condition affecting the right lower eyelid where the nerves controlling eyelid movement are not functioning properly, causing abnormal eyelid position or movement. H02.512 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).
H02.512 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 (right eye) and eyelid location (lower) are documented in the medical record.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.512 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify laterality (right eye) and eyelid location (lower) are documented in the medical record
- •Distinguish from other eyelid conditions like ptosis or entropion which have different codes