H21.232 ICD-10-CM Code: Degeneration of iris (pigmentary), 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)
H21.232
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceDegeneration of iris (pigmentary), left eye
This condition involves the breakdown or deterioration of the pigmented layer of the iris in the left eye, which can affect the eye's appearance and function. The iris is the colored part of the eye that controls how much light enters.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
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Code Book Path
Inclusion Terms
Official- Translucency of iris
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H21.232 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H21.232 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H21.232 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H21.232 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H21.232 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H21.232 in this effective period.
Buddy Documentation Tip
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 H21.232 an HCC code?
No. H21.232 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
H21.232 is the ICD-10-CM diagnosis code for degeneration of iris (pigmentary), left eye. This condition involves the breakdown or deterioration of the pigmented layer of the iris in the left eye, which can affect the eye's appearance and function. The iris is the colored part of the eye that controls how much light enters. H21.232 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).
H21.232 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 laterality is documented in the medical record as 'left eye' to support the use of the '2' laterality indicator in this code.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H21.232 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure laterality is documented in the medical record as 'left eye' to support the use of the '2' laterality indicator in this code
- •Distinguish between pigmentary degeneration and other iris conditions (such as atrophy or heterochromia) as they have different ICD-10-CM codes