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H10.409

Billable

Unspecified chronic conjunctivitis, unspecified eye

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is H10.409 an HCC code?

No. H10.409 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

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

What This Code Means

H10.409 is the ICD-10-CM diagnosis code for unspecified chronic conjunctivitis, unspecified eye. Long-term inflammation of the clear membrane covering the white part of the eye with unknown cause, but the specific eye affected is not documented. H10.409 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering disorders of conjunctiva (h10-h11).

H10.409 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.

Use only when laterality cannot be determined from documentation; this is a less specific code.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H10.409 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use only when laterality cannot be determined from documentation; this is a less specific code
  • Query provider to determine unilateral vs. bilateral involvement for more accurate coding

Code Hierarchy

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