H02.514
BillableAbnormal innervation syndrome left upper eyelid
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H02.514 an HCC code?
No. H02.514 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
H02.514 is the ICD-10-CM diagnosis code for abnormal innervation syndrome left upper eyelid. This condition involves abnormal nerve signals to the muscles of the left upper eyelid, causing involuntary or uncontrolled eyelid movements or positioning. It results from nerve dysfunction affecting how the eyelid muscles receive and respond to commands. H02.514 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).
H02.514 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 left upper eyelid; if bilateral, code both H02.514 (left) and H02.513 (right) separately.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.514 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 left upper eyelid; if bilateral, code both H02.514 (left) and H02.513 (right) separately
- •Ensure the abnormal innervation is confirmed by clinical examination or testing; distinguish from other eyelid conditions like ptosis or blepharospasm which have different codes