Question 1

What is ICD-10 code H18.711?

Accepted Answer

H18.711 is the ICD-10-CM diagnosis code for corneal ectasia, right eye. A condition where the cornea of the right eye becomes abnormally thin and bulges outward, causing a cone-like protrusion. H18.711 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).

H18.711 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.

Ectasia indicates corneal thinning with outward bulging; distinguish from keratoconus which is a specific type of ectasia.

Question 2

Is H18.711 an HCC code?

Accepted Answer

No. H18.711 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is H18.711 billable?

Accepted Answer

Yes. H18.711 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. H18.711 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

What is the V28 vs V24 difference for H18.711?

Accepted Answer

H18.711 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards H18.711 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

Question 5

What should coders know when reporting H18.711?

Accepted Answer

Ectasia indicates corneal thinning with outward bulging; distinguish from keratoconus which is a specific type of ectasia Ensure documentation clearly identifies the right eye and confirms ectasia rather than other corneal deformities

HCC Buddy Code Card

H18.711

Is H18.711 an HCC code?

Get the V28 RAF + MEAT cheat sheet

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Work H18.711 in HCC Buddy

H18.711 ICD-10-CM Code: Corneal ectasia, right eye

HCC Buddy Code Card

H18.711

Is H18.711 an HCC code?

Get the V28 RAF + MEAT cheat sheet

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Work H18.711 in HCC Buddy