H30.143 ICD-10-CM Code: Acute posterior multifocal placoid pigment epitheliopathy, bilateral
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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of choroid and retina (H30-H36)
H30.143
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAcute posterior multifocal placoid pigment epitheliopathy, bilateral
This is an eye condition where multiple small, flat spots of inflammation appear in the back layer of both eyes, causing sudden vision problems and sensitivity to light. It typically affects young, healthy adults and usually improves on its own over several weeks to months.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for H30.143 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H30.143 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H30.143 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H30.143 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H30.143 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H30.143 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H30.143 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is H30.143 an HCC code?
No. H30.143 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- H30.143
- Description
- Acute posterior multifocal placoid pigment epitheliopathy, bilateral
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
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
H30.143 is the ICD-10-CM diagnosis code for acute posterior multifocal placoid pigment epitheliopathy, bilateral. This is an eye condition where multiple small, flat spots of inflammation appear in the back layer of both eyes, causing sudden vision problems and sensitivity to light. It typically affects young, healthy adults and usually improves on its own over several weeks to months. H30.143 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering disorders of choroid and retina (h30-h36).
H30.143 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.
Verify that the condition is documented as bilateral (affecting both eyes) before assigning this code; if only one eye is affected, use the unilateral code H30.141 instead.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H30.143 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify that the condition is documented as bilateral (affecting both eyes) before assigning this code; if only one eye is affected, use the unilateral code H30.141 instead
- •Ensure the documentation specifies 'acute posterior multifocal placoid pigment epitheliopathy' and confirms it is in the acute phase; this code should not be used for chronic or resolved cases

