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H18.549 ICD-10-CM Code: Lattice corneal dystrophy, unspecified eye

H18.549 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software

ICD-10-CM Code View

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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)

H18.549

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

Lattice corneal dystrophy, unspecified eye

A hereditary corneal condition where a lattice-like pattern of deposits forms in the cornea, but the affected eye is not specified.

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
H18.5Hereditary corneal dystrophies
H18.54Lattice corneal dystrophy
H18.549Lattice corneal dystrophy, unspecified eye

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H18.549 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H18.549 in this effective period.

Related Child Codes

Official
H18.541Lattice corneal dystrophy, right eye
H18.542Lattice corneal dystrophy, left eye
H18.543Lattice corneal dystrophy, bilateral

Includes

Official

ICD-10-CM does not list Includes notes for H18.549 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for H18.549 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H18.549 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H18.549 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H18.549 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Use this code only when laterality cannot be determined from documentation
Query the provider if possible to determine which eye is affected for more specific coding

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is H18.549 an HCC code?

No. H18.549 is a billable ICD-10-CM code with no mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code
H18.549
Description
Lattice corneal dystrophy, unspecified eye
HCC (V28)
No CMS-HCC V28 mapping
RAF reference coefficient
Billable
Yes
Payment year
2026

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

H18.549 is the ICD-10-CM diagnosis code for lattice corneal dystrophy, unspecified eye. A hereditary corneal condition where a lattice-like pattern of deposits forms in the cornea, but the affected eye is not specified. H18.549 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).

H18.549 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Use this code only when laterality cannot be determined from documentation.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for H18.549 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use this code only when laterality cannot be determined from documentation
  • Query the provider if possible to determine which eye is affected for more specific coding

Child Codes

Code Hierarchy

H18.549 code history

Code setChange
FY2021 (effective Oct 1, 2020)Added to the code set

Source: official CMS ICD-10-CM order and addenda files, FY2016 through FY2027.

Work H18.549 in HCC Buddy

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