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H10.412

Billable

Chronic giant papillary conjunctivitis, left eye

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

Is H10.412 an HCC code?

No. H10.412 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

H10.412 is the ICD-10-CM diagnosis code for chronic giant papillary conjunctivitis, left eye. Long-term inflammation of the eye's clear membrane with formation of large bumps on the inner eyelid, affecting the left eye only, often associated with contact lens wear. H10.412 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).

H10.412 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.

Giant papillary conjunctivitis is a specific chronic condition often related to contact lens use or prosthesis; document the trigger if known.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H10.412 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Giant papillary conjunctivitis is a specific chronic condition often related to contact lens use or prosthesis; document the trigger if known
  • The '2' indicates left eye; verify laterality in documentation before assigning this code

Code Hierarchy

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