H33.042 ICD-10-CM Code: Retinal detachment with retinal dialysis, 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)
H33.042
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceRetinal detachment with retinal dialysis, left eye
The retina has separated from the eye wall in the left eye due to a retinal dialysis, which is a separation of the retina from the ciliary body.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for H33.042 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H33.042 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H33.042 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H33.042 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H33.042 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H33.042 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H33.042 in this effective period.
Buddy Documentation Tip
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 H33.042 an HCC code?
No. H33.042 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- H33.042
- Description
- Retinal detachment with retinal dialysis, left eye
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- 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
H33.042 is the ICD-10-CM diagnosis code for retinal detachment with retinal dialysis, left eye. The retina has separated from the eye wall in the left eye due to a retinal dialysis, which is a separation of the retina from the ciliary body. H33.042 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).
H33.042 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.
Retinal dialysis typically occurs at the equator or base of the retina.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H33.042 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Retinal dialysis typically occurs at the equator or base of the retina
- •Verify left eye laterality is clearly documented in the clinical record