H34.219
BillablePartial 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 H34.219 an HCC code?
No. H34.219 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
H34.219 is the ICD-10-CM diagnosis code for partial retinal artery occlusion, unspecified eye. A partial blockage of a retinal artery branch when the specific eye affected is not documented or specified. H34.219 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).
H34.219 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 unspecified codes only when laterality cannot be determined from documentation; query provider if possible.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H34.219 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use unspecified codes only when laterality cannot be determined from documentation; query provider if possible
- •Unspecified codes should be avoided when documentation allows for more specific coding