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H05 ICD-10-CM Code: Disorders of orbit

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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)

H05

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Disorders of orbit

Disorders of orbit

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
H0Disorders of eyelid, lacrimal system and orbit (H00-H05)
H05Disorders of orbit

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H05 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H05 in this effective period.

Related Child Codes

Official
H05.0Acute inflammation of orbit
H05.1Chronic inflammatory disorders of orbit
H05.2Exophthalmic conditions
H05.3Deformity of orbit
H05.4Enophthalmos

Includes

Official

ICD-10-CM does not list Includes notes for H05 in this effective period.

Excludes 1

Official
  • congenital malformation of orbit (Q10.7)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H05 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H05 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H05 in this effective period.

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.

Coder workflow notes

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What This Code Means

H05 is the ICD-10-CM diagnosis code for disorders of orbit. H05 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).

Header codes like H05 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at H05's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H05 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

  • congenital malformation of orbit (Q10.7)

Child Codes

Code Hierarchy

H05Disorders of orbit
H05Disorders of orbit

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