H02.823 ICD-10-CM Code: Cysts of right eye, unspecified 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)
H02.823
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCysts of right eye, unspecified eyelid
A fluid-filled sac or bump that has formed on the right eyelid, but the specific type or exact location on the eyelid has not been identified. These cysts are usually benign and may cause mild irritation or cosmetic concerns.
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
Code Trumping
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Code Book Path
Inclusion Terms
Official- Sebaceous cyst of eyelid
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H02.823 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H02.823 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H02.823 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H02.823 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H02.823 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H02.823 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 H02.823 an HCC code?
No. H02.823 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
H02.823 is the ICD-10-CM diagnosis code for cysts of right eye, unspecified eyelid. A fluid-filled sac or bump that has formed on the right eyelid, but the specific type or exact location on the eyelid has not been identified. These cysts are usually benign and may cause mild irritation or cosmetic concerns. H02.823 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).
H02.823 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 whether the cyst location is truly unspecified; if the provider documents a specific eyelid location (upper vs. lower), use a more specific code (H02.821 for upper or H02.822 for lower).
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H02.823 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify whether the cyst location is truly unspecified; if the provider documents a specific eyelid location (upper vs. lower), use a more specific code (H02.821 for upper or H02.822 for lower)
- •This code requires laterality (right eye specified); ensure documentation confirms right eye involvement and not bilateral or left eye involvement