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H05.311 ICD-10-CM Code: Atrophy of right orbit

H05.311 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools

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Code lookupH05.311

FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of eyelid, lacrimal system and orbit (H00-H05)

H05.311

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Atrophy of right orbit

A wasting away or shrinkage of the tissues and structures of the right eye socket.

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Inclusion Terms

Official

No inclusion terms are included in this display for H05.311. Check the code and parent instructions in the Code Book.

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

Includes

Official

No Includes notes are included in this display for H05.311. Check the code and parent instructions in the Code Book.

Excludes 1

Official
  • congenital malformation of orbit (Q10.7)Inherited from H05, H05.3
  • congenital deformity of orbit (Q10.7)Inherited from H05, H05.3
  • hypertelorism (Q75.2)Inherited from H05, H05.3

Code First

Official

No Code First sequencing instructions are included in this display for H05.311. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for H05.311. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for H05.311. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
Confirm atrophy is specifically documented rather than other orbital deformities
Investigate for underlying causes such as trauma, inflammation, or systemic disease

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 H05.311 an HCC code?

No. H05.311 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
H05.311
Description
Atrophy of right orbit
HCC (V28)
No CMS-HCC V28 mapping
RAF reference coefficient
Billable
Yes
Payment year
2026

Coder workflow notes

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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

H05.311 is the ICD-10-CM diagnosis code for atrophy of right orbit. A wasting away or shrinkage of the tissues and structures of the right eye socket. H05.311 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).

H05.311 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 atrophy is specifically documented rather than other orbital deformities.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for H05.311 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Confirm atrophy is specifically documented rather than other orbital deformities
  • Investigate for underlying causes such as trauma, inflammation, or systemic disease

Child Codes

Code Hierarchy

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