HCC Buddy Code Card
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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)
H16.329
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceDiffuse interstitial keratitis, unspecified eye
This code describes inflammation of the cornea (the clear front part of the eye) that is spread throughout its layers, but the specific eye affected is not documented. This condition causes corneal clouding and can affect vision.
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
Code Trumping
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Code Book Path
Inclusion Terms
Official- Cogan's syndrome
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H16.329 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H16.329 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H16.329 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H16.329 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H16.329 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H16.329 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 H16.329 an HCC code?
No. H16.329 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
H16.329 is the ICD-10-CM diagnosis code for diffuse interstitial keratitis, unspecified eye. This code describes inflammation of the cornea (the clear front part of the eye) that is spread throughout its layers, but the specific eye affected is not documented. This condition causes corneal clouding and can affect vision. H16.329 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).
H16.329 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.
Always attempt to determine which eye is affected (right, left, or bilateral) and use the appropriate 7th character code (1 for right eye, 2 for left eye, 3 for bilateral) rather than defaulting to unspecified (9).
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H16.329 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Always attempt to determine which eye is affected (right, left, or bilateral) and use the appropriate 7th character code (1 for right eye, 2 for left eye, 3 for bilateral) rather than defaulting to unspecified (9)
- •Investigate the underlying cause of the keratitis, as diffuse interstitial keratitis is often associated with syphilis, Lyme disease, or other systemic infections, and code the etiology when documented