H16.303 ICD-10-CM Code: Unspecified interstitial keratitis, 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)
H16.303
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceUnspecified interstitial keratitis, bilateral
This code describes inflammation of the cornea (the clear front part of the eye) affecting both eyes, where the specific type or cause of the inflammation is not specified. It's a condition that can cause eye 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 H16.303 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H16.303 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H16.303 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H16.303 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H16.303 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H16.303 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H16.303 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 H16.303 an HCC code?
No. H16.303 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
H16.303 is the ICD-10-CM diagnosis code for unspecified interstitial keratitis, bilateral. This code describes inflammation of the cornea (the clear front part of the eye) affecting both eyes, where the specific type or cause of the inflammation is not specified. It's a condition that can cause eye pain, redness, and vision problems in both eyes. H16.303 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).
H16.303 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 that the condition is documented as bilateral (affecting both eyes) before assigning this code; if only one eye is affected, use the unilateral code H16.301 or H16.302 instead.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H16.303 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify that the condition is documented as bilateral (affecting both eyes) before assigning this code; if only one eye is affected, use the unilateral code H16.301 or H16.302 instead
- •If the underlying cause of the keratitis is documented (such as syphilis, Lyme disease, or other infectious/systemic conditions), consider using a more specific code from the H16.0-H16.2 range rather than the unspecified code H16.303