H34.00
BillableTransient retinal artery occlusion, unspecified eye
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H34.00 an HCC code?
No. H34.00 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
H34.00 is the ICD-10-CM diagnosis code for transient retinal artery occlusion, unspecified eye. A blood vessel in the retina is temporarily blocked, reducing blood flow to the eye, but the blockage resolves on its own. Vision may be temporarily affected but typically returns to normal. H34.00 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).
H34.00 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 this code only when the specific eye is not documented; query the provider for laterality information if not specified.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H34.00 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when the specific eye is not documented; query the provider for laterality information if not specified
- •The term 'transient' indicates temporary blockage; ensure documentation supports that vision returned to baseline