H30.892 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools

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Code lookupH30.892

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of choroid and retina (H30-H36)

H30.892

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

Other chorioretinal inflammations, left eye

This code describes inflammation of the choroid and retina (the light-sensitive layers at the back of the eye) in the left eye that doesn't fit into other specific categories. This condition can cause vision problems, floaters, or flashing lights.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

H30.8Other chorioretinal inflammations H30.89Other chorioretinal inflammations H30.892Other chorioretinal inflammations, left eye

Inclusion Terms

Official

No inclusion terms are included in this display for H30.892. Check the code and parent instructions in the Code Book.

Excludes 2

Official

certain conditions originating in the perinatal period (P04-P96)Inherited from H00-H59
certain infectious and parasitic diseases (A00-B99)Inherited from H00-H59
complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from H00-H59
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from H00-H59
diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)Inherited from H00-H59
endocrine, nutritional and metabolic diseases (E00-E88)Inherited from H00-H59
injury (trauma) of eye and orbit (S05.-)Inherited from H00-H59
injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from H00-H59
neoplasms (C00-D49)Inherited from H00-H59
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from H00-H59
syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)Inherited from H00-H59

Related Codes

Official

H30.891Other chorioretinal inflammations, right eye H30.893Other chorioretinal inflammations, bilateral H30.899Other chorioretinal inflammations, unspecified eye

Includes

Official

No Includes notes are included in this display for H30.892. Check the code and parent instructions in the Code Book.

Excludes 1

Official

No Excludes 1 notes are included in this display for H30.892. Check the code and parent instructions in the Code Book.

Code First

Official

No Code First sequencing instructions are included in this display for H30.892. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for H30.892. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for H30.892. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Verify the laterality is documented as left eye only; if bilateral, you would need a separate code for the right eye (H30.891)

Ensure the medical record specifies this is 'other' chorioretinal inflammation, meaning it doesn't meet criteria for more specific diagnoses like acute retinal necrosis or toxoplasmosis

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 H30.892 an HCC code?

No. H30.892 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code: H30.892
Description: Other chorioretinal inflammations, left eye
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

Coder workflow notes

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What This Code Means

H30.892 is the ICD-10-CM diagnosis code for other chorioretinal inflammations, left eye. This code describes inflammation of the choroid and retina (the light-sensitive layers at the back of the eye) in the left eye that doesn't fit into other specific categories. This condition can cause vision problems, floaters, or flashing lights. H30.892 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).

H30.892 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Verify the laterality is documented as left eye only; if bilateral, you would need a separate code for the right eye (H30.891).

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for H30.892 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify the laterality is documented as left eye only; if bilateral, you would need a separate code for the right eye (H30.891)
•Ensure the medical record specifies this is 'other' chorioretinal inflammation, meaning it doesn't meet criteria for more specific diagnoses like acute retinal necrosis or toxoplasmosis