H25.12 ICD-10-CM Code: Age-related nuclear cataract, left eye
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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of lens (H25-H28)
H25.12
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAge-related nuclear cataract, left eye
A clouding of the lens in the left eye that develops as part of the normal aging process, specifically affecting the central (nuclear) part of the lens. This condition causes progressive vision problems and is one of the most common types of cataracts in older adults.
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
Code Trumping
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Code Book Path
Inclusion Terms
Official- Cataracta brunescens
- Nuclear sclerosis cataract
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H25.12 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H25.12 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H25.12 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H25.12 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H25.12 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H25.12 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 H25.12 an HCC code?
No. H25.12 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
H25.12 is the ICD-10-CM diagnosis code for age-related nuclear cataract, left eye. A clouding of the lens in the left eye that develops as part of the normal aging process, specifically affecting the central (nuclear) part of the lens. This condition causes progressive vision problems and is one of the most common types of cataracts in older adults. H25.12 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering disorders of lens (h25-h28).
H25.12 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.
Always specify laterality (left eye = H25.12, right eye = H25.11, bilateral = H25.13) as this is required for proper coding.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H25.12 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Always specify laterality (left eye = H25.12, right eye = H25.11, bilateral = H25.13) as this is required for proper coding
- •Use this code only for age-related nuclear cataracts; if the cataract is due to trauma, medication, or other specific causes, use a different H25 subcategory or code from a different category