H31.413
BillableHemorrhagic choroidal detachment, bilateral
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H31.413 an HCC code?
No. H31.413 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
H31.413 is the ICD-10-CM diagnosis code for hemorrhagic choroidal detachment, bilateral. Separation of the choroid layer from the underlying tissue affecting both eyes with bleeding between the layers in both eyes. H31.413 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).
H31.413 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.
Bilateral hemorrhagic choroidal detachment is a serious condition; verify both eyes are documented as affected.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H31.413 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Bilateral hemorrhagic choroidal detachment is a serious condition; verify both eyes are documented as affected
- •Ensure the hemorrhagic component is clearly noted in the clinical documentation