H34.212
BillablePartial retinal artery occlusion, left eye
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H34.212 an HCC code?
No. H34.212 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
H34.212 is the ICD-10-CM diagnosis code for partial retinal artery occlusion, left eye. A partial blockage of one of the smaller branches of the retinal artery in the left eye, affecting vision in a portion of that eye. H34.212 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).
H34.212 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.
Verify laterality documentation to ensure correct code selection between right (H34.211) and left (H34.212).
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H34.212 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify laterality documentation to ensure correct code selection between right (H34.211) and left (H34.212)
- •Document the extent of retinal involvement and any associated vision loss for clinical correlation