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H18.531 ICD-10-CM Code: Granular corneal dystrophy, 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)

H18.531

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

Granular corneal dystrophy, right eye

A hereditary corneal condition characterized by granular deposits in the cornea of the right eye, causing progressive vision problems and corneal clouding.

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
H18.5Hereditary corneal dystrophies
H18.53Granular corneal dystrophy
H18.531Granular corneal dystrophy, right eye

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H18.531 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H18.531 in this effective period.

Related Child Codes

Official
H18.532Granular corneal dystrophy, left eye
H18.533Granular corneal dystrophy, bilateral
H18.539Granular corneal dystrophy, unspecified eye

Includes

Official

ICD-10-CM does not list Includes notes for H18.531 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for H18.531 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H18.531 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H18.531 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H18.531 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Confirm 'granular' type is documented to distinguish from other corneal dystrophies like lattice or macular types
Ensure right eye laterality is clearly documented in the medical record

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 H18.531 an HCC code?

No. H18.531 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

H18.531 is the ICD-10-CM diagnosis code for granular corneal dystrophy, right eye. A hereditary corneal condition characterized by granular deposits in the cornea of the right eye, causing progressive vision problems and corneal clouding. H18.531 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).

H18.531 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.

Confirm 'granular' type is documented to distinguish from other corneal dystrophies like lattice or macular types.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H18.531 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Confirm 'granular' type is documented to distinguish from other corneal dystrophies like lattice or macular types
  • Ensure right eye laterality is clearly documented in the medical record

Child Codes

Code Hierarchy

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