Question 1

What is ICD-10 code H33.329?

Accepted Answer

H33.329 is the ICD-10-CM diagnosis code for round hole, unspecified eye. A round hole or circular opening in the retina of an unspecified eye that has not caused the retina to detach. H33.329 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).

H33.329 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.

This unspecified code should be used only when the affected eye is not documented; always attempt to determine laterality from the medical record.

Question 2

Is H33.329 an HCC code?

Accepted Answer

No. H33.329 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is H33.329 billable?

Accepted Answer

Yes. H33.329 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. H33.329 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.

Question 4

Which HCC does H33.329 map to under V28?

Accepted Answer

H33.329 does not map to a CMS-HCC V28 payment category. Check the current CMS-HCC V28 model file for payment year 2026 rather than an older V24 tip sheet.

Question 5

What does H33.329 pay in RAF?

Accepted Answer

H33.329 has no separately stated V28 community RAF weight. If it is not a V28 payment HCC, it adds nothing to a community RAF score.

Question 6

What is the V28 vs V24 difference for H33.329?

Accepted Answer

H33.329 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither community model rewards H33.329 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's V28/V24 community RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a community payment HCC.

Question 7

What documentation supports H33.329?

Accepted Answer

This unspecified code should be used only when the affected eye is not documented; always attempt to determine laterality from the medical record. If eye laterality is documented, assign the appropriate specific code (H33.321, H33.322, or H33.323). H33.329 is not a CMS-HCC payment code, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

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H33.329

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H33.329 ICD-10-CM Code: Round hole, unspecified eye

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H33.329

Is H33.329 an HCC code?

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What This Code Means

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Child Codes

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Work H33.329 in HCC Buddy