What is ICD-10 code H33.012?

H33.012 is the ICD-10-CM diagnosis code for Retinal detachment with single break, left eye. The retina has separated from the back of the left eye due to a single tear or break in the retinal tissue. H33.012 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. H33.012 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. H33.012 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. H33.012 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does H33.012 map to under V28?

H33.012 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

What RAF reference is published for H33.012?

H33.012 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

What is the V28 vs V24 difference for H33.012?

H33.012 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

What documentation supports H33.012?

Verify laterality is documented as left eye in the clinical record This code is specific to single breaks; multiple breaks require a different code H33.012 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

2026 ICD-10-CM H33.012: Retinal detachment with single

H33.012 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software

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Code lookupH33.012

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

H33.012

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

Retinal detachment with single break, left eye

The retina has separated from the back of the left eye due to a single tear or break in the retinal tissue.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

H33.0Retinal detachment with retinal break H33.01Retinal detachment with single break H33.012Retinal detachment with single break, left eye

Inclusion Terms

Official

Rhegmatogenous retinal detachmentInherited from H33.0

Excludes 2

Official

certain conditions originating in the perinatal period (P04-P96)Inherited from H00-H59
certain infectious and parasitic diseases (A00-B99)Inherited from H00-H59
complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from H00-H59
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from H00-H59
diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)Inherited from H00-H59
endocrine, nutritional and metabolic diseases (E00-E88)Inherited from H00-H59
injury (trauma) of eye and orbit (S05.-)Inherited from H00-H59
injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from H00-H59
neoplasms (C00-D49)Inherited from H00-H59
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from H00-H59
syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)Inherited from H00-H59

Related Codes

Official

H33.011Retinal detachment with single break, right eye H33.013Retinal detachment with single break, bilateral H33.019Retinal detachment with single break, unspecified eye

Includes

Official

No Includes notes are included in this display for H33.012. Check the code and parent instructions in the Code Book.

Excludes 1

Official

detachment of retinal pigment epithelium (H35.72-, H35.73-)Inherited from H33, H33.0
serous retinal detachment (without retinal break) (H33.2-)Inherited from H33, H33.0

Code First

Official

No Code First sequencing instructions are included in this display for H33.012. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for H33.012. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for H33.012. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Verify laterality is documented as left eye in the clinical record

This code is specific to single breaks; multiple breaks require a different code

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 H33.012 an HCC code?

No. H33.012 is a billable ICD-10-CM code with no mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code: H33.012
Description: Retinal detachment with single break, left eye
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
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

H33.012 is the ICD-10-CM diagnosis code for retinal detachment with single break, left eye. The retina has separated from the back of the left eye due to a single tear or break in the retinal tissue. H33.012 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).

H33.012 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Verify laterality is documented as left eye in the clinical record.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for H33.012 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.