Question 1

What is ICD-10 code H05.321?

Accepted Answer

H05.321 is the ICD-10-CM diagnosis code for deformity of right orbit due to bone disease. An abnormal shape or structure of the right eye socket caused by an underlying bone disease or disorder. H05.321 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).

H05.321 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.

Identify and code the underlying bone disease separately (e.g., osteoporosis, Paget's disease).

Question 2

Is H05.321 an HCC code?

Accepted Answer

H05.321 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

Question 3

Is H05.321 billable?

Accepted Answer

Yes. H05.321 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. H05.321 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

Which HCC does H05.321 map to under V28?

Accepted Answer

H05.321 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

Question 5

What RAF reference is published for H05.321?

Accepted Answer

H05.321 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

Question 6

What is the V28 vs V24 difference for H05.321?

Accepted Answer

H05.321 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

Question 7

What documentation supports H05.321?

Accepted Answer

Identify and code the underlying bone disease separately (e.g., osteoporosis, Paget's disease) Ensure documentation specifies the bone disease as the cause of the orbital deformity H05.321 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

Question 8

Can H05.321 be a primary diagnosis?

Accepted Answer

Yes. H05.321 carries no code-first instruction in the FY2026 tabular, so it can be the first-listed diagnosis when it is the condition chiefly responsible for the encounter and the note supports it, and it can also be reported as a secondary diagnosis. For risk adjustment the order does not matter; the V28 category is the same either way.

Question 9

Which codes cannot be reported with H05.321?

Accepted Answer

The Excludes1 note that applies to H05.321 lists congenital malformation of orbit (Q10.7); congenital deformity of orbit (Q10.7); hypertelorism (Q75.2). An Excludes1 condition is not reported together with H05.321; report one or the other, unless the two conditions are unrelated, which the ICD-10-CM Official Guidelines (Section I.A.12.a) allow. The Excludes2 note lists certain conditions originating in the perinatal period (P04-P96); certain infectious and parasitic diseases (A00-B99); complications of pregnancy, childbirth and the puerperium (O00-O9A); congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99); and 9 more (see the notes on this page); those are separate conditions that may be reported together with H05.321 when both are documented.

HCC Buddy Code Card

H05.321

Is H05.321 an HCC code?

Get the V28 mapping + MEAT cheat sheet

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Also searched as

Work H05.321 in HCC Buddy

H05.321 ICD-10-CM Code: Deformity of right orbit due to bone disease

HCC Buddy Code Card

H05.321

Is H05.321 an HCC code?

Get the V28 mapping + MEAT cheat sheet

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Also searched as

Work H05.321 in HCC Buddy