H16.023 ICD-10-CM Code: Ring corneal ulcer, bilateral
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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)
H16.023
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceRing corneal ulcer, bilateral
A ring-shaped ulcer (open sore) that affects both eyes on the cornea, which is the clear front part of the eye. This condition causes pain, redness, and vision problems in both eyes.
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 H16.023 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H16.023 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H16.023 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H16.023 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H16.023 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H16.023 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H16.023 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 H16.023 an HCC code?
No. H16.023 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
H16.023 is the ICD-10-CM diagnosis code for ring corneal ulcer, bilateral. A ring-shaped ulcer (open sore) that affects both eyes on the cornea, which is the clear front part of the eye. This condition causes pain, redness, and vision problems in both eyes. H16.023 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).
H16.023 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.
Verify documentation confirms the ulcer is ring-shaped and affects both eyes before assigning the bilateral code; unilateral cases require different codes (H16.021 or H16.022).
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H16.023 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation confirms the ulcer is ring-shaped and affects both eyes before assigning the bilateral code; unilateral cases require different codes (H16.021 or H16.022)
- •Investigate the underlying cause (infection, trauma, autoimmune disease) as this may require additional diagnosis codes and can affect treatment decisions