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H33.119 ICD-10-CM Code: Cyst of ora serrata, unspecified eye

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

H33.119

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

Cyst of ora serrata, unspecified eye

A fluid-filled sac that develops on the ora serrata, which is the junction between the retina and the ciliary body in the eye. This condition affects an unspecified eye and may cause vision problems or eye discomfort depending on the cyst's size and location.

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
H33.1Retinoschisis and retinal cysts
H33.11Cyst of ora serrata
H33.119Cyst of ora serrata, unspecified eye

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H33.119 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H33.119 in this effective period.

Related Child Codes

Official
H33.111Cyst of ora serrata, right eye
H33.112Cyst of ora serrata, left eye
H33.113Cyst of ora serrata, bilateral

Includes

Official

ICD-10-CM does not list Includes notes for H33.119 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for H33.119 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H33.119 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H33.119 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H33.119 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Use the 7th character to specify laterality: 1 for right eye, 2 for left eye, or 3 for bilateral when applicable; this code requires a 7th character for complete coding
Distinguish between cysts of ora serrata (H33.11-) and other retinal cysts or detachments to ensure accurate code selection

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 H33.119 an HCC code?

No. H33.119 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

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

H33.119 is the ICD-10-CM diagnosis code for cyst of ora serrata, unspecified eye. A fluid-filled sac that develops on the ora serrata, which is the junction between the retina and the ciliary body in the eye. This condition affects an unspecified eye and may cause vision problems or eye discomfort depending on the cyst's size and location. H33.119 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).

H33.119 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.

Use the 7th character to specify laterality: 1 for right eye, 2 for left eye, or 3 for bilateral when applicable; this code requires a 7th character for complete coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H33.119 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use the 7th character to specify laterality: 1 for right eye, 2 for left eye, or 3 for bilateral when applicable; this code requires a 7th character for complete coding
  • Distinguish between cysts of ora serrata (H33.11-) and other retinal cysts or detachments to ensure accurate code selection

Child Codes

Code Hierarchy

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