H31.093 ICD-10-CM Code: Other chorioretinal scars, bilateral
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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of choroid and retina (H30-H36)
H31.093
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther chorioretinal scars, bilateral
Scarring or permanent damage to the tissue layer beneath the retina in both eyes from causes other than solar exposure, such as inflammation, infection, or previous eye disease.
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
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Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for H31.093 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H31.093 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H31.093 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H31.093 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H31.093 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H31.093 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H31.093 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 H31.093 an HCC code?
No. H31.093 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
H31.093 is the ICD-10-CM diagnosis code for other chorioretinal scars, bilateral. Scarring or permanent damage to the tissue layer beneath the retina in both eyes from causes other than solar exposure, such as inflammation, infection, or previous eye disease. H31.093 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).
H31.093 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.
Confirm bilateral involvement is documented before using this code; do not assume bilateral if only one eye is mentioned.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H31.093 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm bilateral involvement is documented before using this code; do not assume bilateral if only one eye is mentioned
- •Consider if the bilateral scars share a common etiology or represent separate events