H05.313 ICD-10-CM Code: Atrophy of bilateral orbit
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)
H05.313
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAtrophy of bilateral orbit
A wasting away or shrinkage of the tissues and structures of both eye sockets.
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
Basket needed
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for H05.313 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H05.313 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H05.313 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H05.313 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H05.313 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H05.313 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H05.313 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 H05.313 an HCC code?
No. H05.313 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
Coder workflow notes
Get the V28 RAF + MEAT cheat sheet
One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. 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
H05.313 is the ICD-10-CM diagnosis code for atrophy of bilateral orbit. A wasting away or shrinkage of the tissues and structures of both eye sockets. H05.313 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).
H05.313 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.
Confirm bilateral involvement is documented; if only one eye affected, use H05.311 or H05.312.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H05.313 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.