H34.211
BillablePartial retinal artery occlusion, right eye
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H34.211 an HCC code?
No. H34.211 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
H34.211 is the ICD-10-CM diagnosis code for partial retinal artery occlusion, right eye. A partial blockage of one of the smaller branches of the retinal artery in the right eye, affecting vision in a portion of that eye. H34.211 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).
H34.211 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.
Distinguish between partial (H34.21x) and complete central occlusion (H34.11x) based on clinical findings and documentation.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H34.211 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.