H31.412
BillableHemorrhagic choroidal detachment, left eye
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H31.412 an HCC code?
No. H31.412 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
H31.412 is the ICD-10-CM diagnosis code for hemorrhagic choroidal detachment, left eye. Separation of the choroid layer from the underlying tissue in the left eye with bleeding between the layers. H31.412 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).
H31.412 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.
The presence of hemorrhage is a key distinguishing feature; confirm this is documented in the clinical record.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H31.412 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •The presence of hemorrhage is a key distinguishing feature; confirm this is documented in the clinical record
- •Ensure left eye laterality is clearly specified in the documentation