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H30.92 ICD-10-CM Code: Unspecified chorioretinal inflammation, left eye

H30.92 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC Buddy coding tools

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

H30.92

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

Unspecified chorioretinal inflammation, 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 when the specific cause or type of inflammation cannot be determined. It's used when a patient has eye inflammation but the exact diagnosis hasn't been clearly identified.

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

Official
H30Chorioretinal inflammation
H30.9Unspecified chorioretinal inflammation
H30.92Unspecified chorioretinal inflammation, left eye

Inclusion Terms

Official
  • Chorioretinitis NOS
  • Choroiditis NOS
  • Neuroretinitis NOS
  • Retinitis NOS
  • Retinochoroiditis NOS

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H30.92 in this effective period.

Related Child Codes

Official
H30.90Unspecified chorioretinal inflammation, unspecified eye
H30.91Unspecified chorioretinal inflammation, right eye
H30.93Unspecified chorioretinal inflammation, bilateral

Includes

Official

ICD-10-CM does not list Includes notes for H30.92 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for H30.92 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H30.92 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H30.92 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H30.92 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Use this code only when the specific type of chorioretinal inflammation cannot be identified; if a more specific diagnosis is documented (such as toxoplasmosis, sarcoidosis, or other known causes), use the more specific code instead
Ensure the laterality is correct—this code is specifically for the left eye; use H30.91 for the right eye or H30.93 for bilateral involvement

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 H30.92 an HCC code?

No. H30.92 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

Code
H30.92
Description
Unspecified chorioretinal inflammation, left eye
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

H30.92 is the ICD-10-CM diagnosis code for unspecified chorioretinal inflammation, 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 when the specific cause or type of inflammation cannot be determined. It's used when a patient has eye inflammation but the exact diagnosis hasn't been clearly identified. H30.92 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).

H30.92 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 the specific type of chorioretinal inflammation cannot be identified; if a more specific diagnosis is documented (such as toxoplasmosis, sarcoidosis, or other known causes), use the more specific code instead.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H30.92 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 the specific type of chorioretinal inflammation cannot be identified; if a more specific diagnosis is documented (such as toxoplasmosis, sarcoidosis, or other known causes), use the more specific code instead
  • Ensure the laterality is correct—this code is specifically for the left eye; use H30.91 for the right eye or H30.93 for bilateral involvement

Child Codes

Code Hierarchy

Work H30.92 in HCC Buddy

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