H34.10 ICD-10-CM Code: Central retinal artery occlusion, unspecified eye
H34.10 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of choroid and retina (H30-H36)
H34.10
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCentral retinal artery occlusion, unspecified eye
The main blood vessel supplying the retina is blocked, cutting off blood flow to the eye. This is a serious condition that can cause sudden vision loss and requires emergency treatment.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for H34.10. Check the code and parent instructions in the Code Book.
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
Includes
OfficialNo Includes notes are included in this display for H34.10. Check the code and parent instructions in the Code Book.
Excludes 1
Official- amaurosis fugax (G45.3)Inherited from H34
Code First
OfficialNo Code First sequencing instructions are included in this display for H34.10. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for H34.10. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for H34.10. Check the code and parent instructions in the Code Book.
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 H34.10 an HCC code?
No. H34.10 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
- H34.10
- Description
- Central retinal artery occlusion, unspecified 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
H34.10 is the ICD-10-CM diagnosis code for central retinal artery occlusion, unspecified eye. The main blood vessel supplying the retina is blocked, cutting off blood flow to the eye. This is a serious condition that can cause sudden vision loss and requires emergency treatment. H34.10 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).
H34.10 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.
Use this code only when the specific eye is not documented; query the provider for laterality if not specified.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for H34.10 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 if not specified
- •Central retinal artery occlusion is a medical emergency; ensure the urgency of the condition is reflected in the clinical documentation and treatment plan

