H02.60
BillableXanthelasma of unspecified eye, unspecified eyelid
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H02.60 an HCC code?
No. H02.60 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
H02.60 is the ICD-10-CM diagnosis code for xanthelasma of unspecified eye, unspecified eyelid. Xanthelasma is a yellowish deposit of cholesterol that forms on the eyelids, typically appearing as small bumps or patches around the eyes. This code indicates the condition is present but the specific eye and eyelid location have not been specified. H02.60 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).
H02.60 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.
Query the provider to determine laterality (right eye, left eye, or bilateral) and specific eyelid location (upper, lower, or both) to assign a more specific code from the H02.6 subcategory.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.60 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Query the provider to determine laterality (right eye, left eye, or bilateral) and specific eyelid location (upper, lower, or both) to assign a more specific code from the H02.6 subcategory
- •Xanthelasma is often associated with hyperlipidemia or familial hypercholesterolemia; consider reviewing the patient's lipid panel results and related diagnoses for complete documentation