H34.239
BillableRetinal artery branch occlusion, unspecified eye
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H34.239 an HCC code?
No. H34.239 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
H34.239 is the ICD-10-CM diagnosis code for retinal artery branch occlusion, unspecified eye. A blood clot or blockage in one of the smaller branches of the artery that supplies blood to the retina (the light-sensitive tissue at the back of the eye), affecting an eye that is not specified as right or left. This condition can cause sudden vision loss or blurred vision in the affected area. H34.239 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).
H34.239 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 (right or left) is not documented; if laterality is known, use H34.231 (right eye) or H34.232 (left eye) instead.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H34.239 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 (right or left) is not documented; if laterality is known, use H34.231 (right eye) or H34.232 (left eye) instead
- •This is typically an acute condition requiring urgent ophthalmologic evaluation; ensure documentation supports the diagnosis and consider querying the provider if eye laterality is missing