Question 1

What is ICD-10 code H26.233?

Accepted Answer

H26.233 is the ICD-10-CM diagnosis code for glaucomatous flecks (subcapsular), bilateral. Small white spots or opacities in the lens of both eyes caused by elevated eye pressure from glaucoma. H26.233 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).

H26.233 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.

Use only when glaucomatous flecks are documented in both eyes.

Question 2

Is H26.233 an HCC code?

Accepted Answer

No. H26.233 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 H26.233 billable?

Accepted Answer

Yes. H26.233 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. H26.233 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 H26.233?

Accepted Answer

H26.233 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 H26.233 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 H26.233?

Accepted Answer

Use only when glaucomatous flecks are documented in both eyes Report the bilateral glaucoma diagnosis code in addition to this cataract code for complete documentation

HCC Buddy Code Card

H26.233

Is H26.233 an HCC code?

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Work H26.233 in HCC Buddy

H26.233 ICD-10-CM Code: Glaucomatous flecks (subcapsular), bilateral

HCC Buddy Code Card

H26.233

Is H26.233 an HCC code?

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Work H26.233 in HCC Buddy