H15.019 ICD-10-CM Code: Anterior scleritis, unspecified eye
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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of sclera, cornea, iris and ciliary body (H15-H22)
H15.019
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAnterior scleritis, unspecified eye
Anterior scleritis is inflammation of the white part of the eye (sclera) located in the front of the eye. This code is used when the specific eye affected is not documented or when both eyes are involved.
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 H15.019 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H15.019 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H15.019 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H15.019 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H15.019 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H15.019 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H15.019 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 H15.019 an HCC code?
No. H15.019 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
H15.019 is the ICD-10-CM diagnosis code for anterior scleritis, unspecified eye. Anterior scleritis is inflammation of the white part of the eye (sclera) located in the front of the eye. This code is used when the specific eye affected is not documented or when both eyes are involved. H15.019 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering disorders of sclera, cornea, iris and ciliary body (h15-h22).
H15.019 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.
If the documentation specifies which eye is affected (right, left, or bilateral), use the more specific codes H15.011 (right eye), H15.012 (left eye), or H15.013 (bilateral) instead of the unspecified code.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H15.019 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •If the documentation specifies which eye is affected (right, left, or bilateral), use the more specific codes H15.011 (right eye), H15.012 (left eye), or H15.013 (bilateral) instead of the unspecified code
- •Scleritis is often associated with systemic autoimmune diseases; review the medical record for underlying conditions like rheumatoid arthritis or lupus that should be coded separately