H31.322 ICD-10-CM Code: Choroidal rupture, left eye
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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of choroid and retina (H30-H36)
H31.322
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceChoroidal rupture, left eye
A choroidal rupture in the left eye is a break or tear in the choroid, which is the layer of blood vessels beneath the retina that supplies oxygen and nutrients to the eye. This condition typically results from trauma or injury to the eye.
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 H31.322 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H31.322 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H31.322 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H31.322 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H31.322 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H31.322 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H31.322 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 H31.322 an HCC code?
No. H31.322 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
H31.322 is the ICD-10-CM diagnosis code for choroidal rupture, left eye. A choroidal rupture in the left eye is a break or tear in the choroid, which is the layer of blood vessels beneath the retina that supplies oxygen and nutrients to the eye. This condition typically results from trauma or injury to the eye. H31.322 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).
H31.322 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 laterality is documented as left eye; if bilateral ruptures exist, code both H31.321 (right eye) and H31.322 (left eye) separately.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H31.322 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.