Question 1

What is ICD-10 code H18.823?

Accepted Answer

H18.823 is the ICD-10-CM diagnosis code for corneal disorder due to contact lens, bilateral. Damage or irritation to the cornea of both eyes caused by wearing contact lenses, affecting the clear front surface of both eyes. H18.823 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).

H18.823 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.

Ensure bilateral involvement is explicitly stated in the medical record.

Question 2

Is H18.823 an HCC code?

Accepted Answer

No. H18.823 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 H18.823 billable?

Accepted Answer

Yes. H18.823 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. H18.823 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 H18.823?

Accepted Answer

H18.823 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 H18.823 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 H18.823?

Accepted Answer

Ensure bilateral involvement is explicitly stated in the medical record Consider if poor contact lens hygiene or prolonged wear is documented as the cause

HCC Buddy Code Card

H18.823

Is H18.823 an HCC code?

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Open H18.823 in the Interactive Encoder

H18.823 ICD-10-CM Code: Corneal disorder due to contact lens, bilateral

HCC Buddy Code Card

H18.823

Is H18.823 an HCC code?

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Open H18.823 in the Interactive Encoder