H18.543 ICD-10-CM Code: Lattice corneal dystrophy, 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)
H18.543
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceLattice corneal dystrophy, bilateral
Lattice corneal dystrophy is a genetic eye condition where abnormal protein deposits form a lattice-like pattern in the cornea (the clear front part of the eye), affecting both eyes. This can cause vision problems, corneal clouding, and recurrent eye irritation.
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 H18.543 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H18.543 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H18.543 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H18.543 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H18.543 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H18.543 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H18.543 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 H18.543 an HCC code?
No. H18.543 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
H18.543 is the ICD-10-CM diagnosis code for lattice corneal dystrophy, bilateral. Lattice corneal dystrophy is a genetic eye condition where abnormal protein deposits form a lattice-like pattern in the cornea (the clear front part of the eye), affecting both eyes. This can cause vision problems, corneal clouding, and recurrent eye irritation. H18.543 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).
H18.543 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 code H18.543; if only one eye is affected, use H18.541 (right eye) or H18.542 (left eye) instead.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H18.543 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 code H18.543; if only one eye is affected, use H18.541 (right eye) or H18.542 (left eye) instead
- •This is a hereditary dystrophy, so consider documenting the family history and whether genetic counseling was provided, as this may support medical necessity for ophthalmology referrals or specialized treatments