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H18.421 ICD-10-CM Code: Band keratopathy, right 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)

H18.421

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Band keratopathy, right eye

A white, opaque band-shaped deposit that forms across the cornea, typically in the interpalpebral zone (the part of the eye exposed when eyelids are open), affecting the right eye.

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
H18.4Corneal degeneration
H18.42Band keratopathy
H18.421Band keratopathy, right eye

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H18.421 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H18.421 in this effective period.

Related Child Codes

Official
H18.422Band keratopathy, left eye
H18.423Band keratopathy, bilateral
H18.429Band keratopathy, unspecified eye

Includes

Official

ICD-10-CM does not list Includes notes for H18.421 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for H18.421 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H18.421 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H18.421 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H18.421 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Band keratopathy is often associated with chronic eye inflammation, hypercalcemia, or previous eye trauma; document the underlying cause if known
Verify laterality is documented as right eye before assigning this specific code

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 H18.421 an HCC code?

No. H18.421 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

H18.421 is the ICD-10-CM diagnosis code for band keratopathy, right eye. A white, opaque band-shaped deposit that forms across the cornea, typically in the interpalpebral zone (the part of the eye exposed when eyelids are open), affecting the right eye. H18.421 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).

H18.421 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.

Band keratopathy is often associated with chronic eye inflammation, hypercalcemia, or previous eye trauma; document the underlying cause if known.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H18.421 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Band keratopathy is often associated with chronic eye inflammation, hypercalcemia, or previous eye trauma; document the underlying cause if known
  • Verify laterality is documented as right eye before assigning this specific code

Child Codes

Code Hierarchy

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