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H21 ICD-10-CM Code: Other disorders of iris and ciliary body

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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)

H21

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Other disorders of iris and ciliary body

Other disorders of iris and ciliary body

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
H2Disorders of sclera, cornea, iris and ciliary body (H15-H22)
H21Other disorders of iris and ciliary body

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H21 in this effective period.

Excludes 2

Official
  • sympathetic uveitis (H44.1-)

Related Child Codes

Official
H21.0Hyphema
H21.1Other vascular disorders of iris and ciliary body
H21.2Degeneration of iris and ciliary body
H21.3Cyst of iris, ciliary body and anterior chamber
H21.4Pupillary membranes

Includes

Official

ICD-10-CM does not list Includes notes for H21 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for H21 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H21 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H21 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H21 in this effective period.

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.

What This Code Means

H21 is the ICD-10-CM diagnosis code for other disorders of iris and ciliary body. H21 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).

Header codes like H21 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at H21's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H21 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 2, Not included here, may code separately

  • sympathetic uveitis (H44.1-)

Child Codes

Code Hierarchy

H21Other disorders of iris and ciliary body
H21Other disorders of iris and ciliary body

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