H05.222 ICD-10-CM Code: Edema of left orbit
H05.222 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of eyelid, lacrimal system and orbit (H00-H05)
H05.222
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceEdema of left orbit
Swelling of the tissues around the left eye due to fluid accumulation in the eye socket.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Orbital congestionInherited from H05.22
Excludes 2
Official- certain conditions originating in the perinatal period (P04-P96)Inherited from H00-H59, H00-H05
- certain infectious and parasitic diseases (A00-B99)Inherited from H00-H59, H00-H05
- complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from H00-H59, H00-H05
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from H00-H59, H00-H05
- diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)Inherited from H00-H59, H00-H05
- endocrine, nutritional and metabolic diseases (E00-E88)Inherited from H00-H59, H00-H05
- injury (trauma) of eye and orbit (S05.-)Inherited from H00-H59, H00-H05
- injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from H00-H59, H00-H05
- neoplasms (C00-D49)Inherited from H00-H59, H00-H05
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from H00-H59, H00-H05
- syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)Inherited from H00-H59, H00-H05
- open wound of eyelid (S01.1-)Inherited from H00-H59, H00-H05
- superficial injury of eyelid (S00.1-, S00.2-)Inherited from H00-H59, H00-H05
Related Codes
Includes
OfficialNo Includes notes are included in this display for H05.222. Check the code and parent instructions in the Code Book.
Excludes 1
Official- congenital malformation of orbit (Q10.7)Inherited from H05
Code First
OfficialNo Code First sequencing instructions are included in this display for H05.222. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for H05.222. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for H05.222. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is H05.222 an HCC code?
No. H05.222 is a billable ICD-10-CM code with no mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- H05.222
- Description
- Edema of left orbit
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
Get the V28 mapping + MEAT cheat sheet
One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.
Free PDF. No card. Unsubscribe anytime.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
H05.222 is the ICD-10-CM diagnosis code for edema of left orbit. Swelling of the tissues around the left eye due to fluid accumulation in the eye socket. H05.222 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).
H05.222 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.
Confirm left eye laterality is explicitly documented in the clinical notes.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for H05.222 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm left eye laterality is explicitly documented in the clinical notes
- •Consider if this is secondary to systemic conditions like thyroid eye disease or orbital cellulitis