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H26.122 ICD-10-CM Code: Partially resolved traumatic cataract, left eye

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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of lens (H25-H28)

H26.122

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Partially resolved traumatic cataract, left eye

A clouding of the lens in the left eye caused by an eye injury that has partially improved or resolved.

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
H26.1Traumatic cataract
H26.12Partially resolved traumatic cataract
H26.122Partially resolved traumatic cataract, left eye

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H26.122 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H26.122 in this effective period.

Related Child Codes

Official
H26.121Partially resolved traumatic cataract, right eye
H26.123Partially resolved traumatic cataract, bilateral
H26.129Partially resolved traumatic cataract, unspecified eye

Includes

Official

ICD-10-CM does not list Includes notes for H26.122 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for H26.122 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H26.122 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H26.122 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H26.122 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Ensure documentation clearly indicates the cataract is partially resolved rather than fully resolved or unchanged
Track the progression of cataract resolution over time for accurate clinical documentation

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 H26.122 an HCC code?

No. H26.122 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

H26.122 is the ICD-10-CM diagnosis code for partially resolved traumatic cataract, left eye. A clouding of the lens in the left eye caused by an eye injury that has partially improved or resolved. H26.122 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).

H26.122 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 documentation clearly indicates the cataract is partially resolved rather than fully resolved or unchanged.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H26.122 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Ensure documentation clearly indicates the cataract is partially resolved rather than fully resolved or unchanged
  • Track the progression of cataract resolution over time for accurate clinical documentation

Child Codes

Code Hierarchy

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