H11.239 ICD-10-CM Code: Symblepharon, unspecified eye
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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of conjunctiva (H10-H11)
H11.239
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceSymblepharon, unspecified eye
Adhesion between the eyelid and eyeball when the specific eye is not identified.
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
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Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for H11.239 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H11.239 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H11.239 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H11.239 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H11.239 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H11.239 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H11.239 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 H11.239 an HCC code?
No. H11.239 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
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
H11.239 is the ICD-10-CM diagnosis code for symblepharon, unspecified eye. Adhesion between the eyelid and eyeball when the specific eye is not identified. H11.239 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).
H11.239 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.
This is a default code; query the provider to determine laterality for more specific coding.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H11.239 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a default code; query the provider to determine laterality for more specific coding
- •Ensure documentation clearly specifies which eye(s) are affected