Question 1

What is ICD-10 code H30.23?

Accepted Answer

H30.23 is the ICD-10-CM diagnosis code for posterior cyclitis, bilateral. Inflammation of the back portion of both eyes' middle layers, affecting the ciliary body and surrounding tissue in both eyes. H30.23 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).

H30.23 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.

Bilateral involvement should be explicitly documented in the medical record; this code indicates both eyes are affected.

Question 2

Is H30.23 an HCC code?

Accepted Answer

No. H30.23 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 H30.23 billable?

Accepted Answer

Yes. H30.23 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. H30.23 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 H30.23?

Accepted Answer

H30.23 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 H30.23 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 H30.23?

Accepted Answer

Bilateral involvement should be explicitly documented in the medical record; this code indicates both eyes are affected When bilateral disease is present, use this code rather than coding each eye separately

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H30.23

Is H30.23 an HCC code?

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Open H30.23 in the Interactive Encoder

H30.23 ICD-10-CM Code: Posterior cyclitis, bilateral

HCC Buddy Code Card

H30.23

Is H30.23 an HCC code?

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Open H30.23 in the Interactive Encoder