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H18.552 ICD-10-CM Code: Macular corneal dystrophy, left 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)

H18.552

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

Macular corneal dystrophy, left eye

A hereditary corneal condition where deposits accumulate in the central cornea of the left eye, causing progressive clouding and vision loss.

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
H18.55Macular corneal dystrophy
H18.552Macular corneal dystrophy, left eye

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H18.552 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H18.552 in this effective period.

Related Child Codes

Official
H18.551Macular corneal dystrophy, right eye
H18.553Macular corneal dystrophy, bilateral
H18.559Macular corneal dystrophy, unspecified eye

Includes

Official

ICD-10-CM does not list Includes notes for H18.552 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for H18.552 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H18.552 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H18.552 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H18.552 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Confirm 'macular' type is documented to distinguish from granular or lattice dystrophies
Verify left eye laterality is documented; use H18.551 for right eye or H18.553 for bilateral

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 H18.552 an HCC code?

No. H18.552 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

H18.552 is the ICD-10-CM diagnosis code for macular corneal dystrophy, left eye. A hereditary corneal condition where deposits accumulate in the central cornea of the left eye, causing progressive clouding and vision loss. H18.552 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).

H18.552 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 'macular' type is documented to distinguish from granular or lattice dystrophies.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H18.552 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Confirm 'macular' type is documented to distinguish from granular or lattice dystrophies
  • Verify left eye laterality is documented; use H18.551 for right eye or H18.553 for bilateral

Child Codes

Code Hierarchy

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