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H34.8332 ICD-10-CM Code: Tributary (branch) retinal vein occlusion, bilateral, stable

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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of choroid and retina (H30-H36)

H34.8332

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Tributary (branch) retinal vein occlusion, bilateral, stable

Tributary (branch) retinal vein occlusion, bilateral, stable

CMS-HCC V28

HCC 298

RAF 0.209

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
H34.83Tributary (branch) retinal vein occlusion
H34.833Tributary (branch) retinal vein occlusion, bilateral
H34.8332Tributary (branch) retinal vein occlusion, bilateral, stable

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H34.8332 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H34.8332 in this effective period.

Related Child Codes

Official
H34.8330Tributary (branch) retinal vein occlusion, bilateral, with macular edema
H34.8331Tributary (branch) retinal vein occlusion, bilateral, with retinal neovascularization

Includes

Official

ICD-10-CM does not list Includes notes for H34.8332 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for H34.8332 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H34.8332 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H34.8332 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H34.8332 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is H34.8332 an HCC code?

Yes. H34.8332 maps to Proliferative Diabetic Retinopathy and Vitreous Hemorrhage under the CMS-HCC V28 risk adjustment model.

HCC Category Mapping

V28HCC 298, Proliferative Diabetic Retinopathy and Vitreous Hemorrhage
0.209

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

MEAT Criteria for H34.8332

For H34.8332to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

  • MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
  • EEvaluate: test results, medication response, or physical findings reviewed by the provider
  • AAssess: explicit mention in the assessment or plan with acknowledgment of status
  • TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed H34.8332 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

H34.8332 is the ICD-10-CM diagnosis code for tributary (branch) retinal vein occlusion, bilateral, stable. H34.8332 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).

Under the CMS-HCC V28 risk adjustment model, H34.8332 maps to Proliferative Diabetic Retinopathy and Vitreous Hemorrhage (HCC 298) with a community, non-dual, aged base RAF weight of 0.209. H34.8332 was not retained as a payment HCC under the older V24 model, so V28 introduced or recategorized it during the 2024–2026 phase-in. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Coders should report H34.8332 only when the provider documentation supports the specific condition described, since more specific codes within the same hierarchy can capture additional clinical detail and may carry a higher RAF weight. Because H34.8332 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H34.8332 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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