H27.03 ICD-10-CM Code: Aphakia, bilateral
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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of lens (H25-H28)
H27.03
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAphakia, bilateral
Absence of the lens in both eyes, affecting vision in both the right and left eye.
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- Acquired absence of lens
- Acquired aphakia
- Aphakia due to trauma
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H27.03 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H27.03 in this effective period.
Excludes 1
Official- cataract extraction status (Z98.4-)
- congenital absence of lens (Q12.3)
- congenital aphakia (Q12.3)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H27.03 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H27.03 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H27.03 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 H27.03 an HCC code?
No. H27.03 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
H27.03 is the ICD-10-CM diagnosis code for aphakia, bilateral. Absence of the lens in both eyes, affecting vision in both the right and left eye. H27.03 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).
H27.03 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 this code only when aphakia is documented in both eyes; verify bilateral status in clinical documentation.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H27.03 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when aphakia is documented in both eyes; verify bilateral status in clinical documentation
- •Bilateral aphakia significantly impacts visual function and may require specialized rehabilitation or optical correction