H16.052 ICD-10-CM Code: Mooren's corneal ulcer, left 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)
H16.052
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceMooren's corneal ulcer, left eye
Mooren's corneal ulcer is a rare, progressive ulceration of the cornea (the clear front part of the eye) that typically affects the left eye and can lead to vision loss if untreated.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for H16.052 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H16.052 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H16.052 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H16.052 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H16.052 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H16.052 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H16.052 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 H16.052 an HCC code?
No. H16.052 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
H16.052 is the ICD-10-CM diagnosis code for mooren's corneal ulcer, left eye. Mooren's corneal ulcer is a rare, progressive ulceration of the cornea (the clear front part of the eye) that typically affects the left eye and can lead to vision loss if untreated. H16.052 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).
H16.052 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.
Mooren's ulcer is an autoimmune condition; verify laterality documentation to ensure accurate code selection between right (H16.051), left (H16.052), or bilateral (H16.053).
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H16.052 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Mooren's ulcer is an autoimmune condition; verify laterality documentation to ensure accurate code selection between right (H16.051), left (H16.052), or bilateral (H16.053)
- •This condition often requires specialist ophthalmology care; document any associated treatments or complications for complete clinical picture