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H35.3123 ICD-10-CM Code: Nonexudative age-related macular degeneration, left eye, advanced atrophic without subfoveal involvement

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

H35.3123

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

Nonexudative age-related macular degeneration, left eye, advanced atrophic without subfoveal involvement

Nonexudative age-related macular degeneration, left eye, advanced atrophic without subfoveal involvement

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
H35.31Nonexudative age-related macular degeneration
H35.312Nonexudative age-related macular degeneration, left eye
H35.3123Nonexudative age-related macular degeneration, left eye, advanced atrophic without subfoveal involvement

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H35.3123 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H35.3123 in this effective period.

Related Child Codes

Official
H35.3120Nonexudative age-related macular degeneration, left eye, stage unspecified
H35.3121Nonexudative age-related macular degeneration, left eye, early dry stage
H35.3122Nonexudative age-related macular degeneration, left eye, intermediate dry stage
H35.3124Nonexudative age-related macular degeneration, left eye, advanced atrophic with subfoveal involvement

Includes

Official

ICD-10-CM does not list Includes notes for H35.3123 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for H35.3123 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H35.3123 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H35.3123 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H35.3123 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 H35.3123 an HCC code?

No. H35.3123 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

Coder workflow notes

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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

H35.3123 is the ICD-10-CM diagnosis code for nonexudative age-related macular degeneration, left eye, advanced atrophic without subfoveal involvement. H35.3123 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).

H35.3123 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.

H35.3123 is a billable ICD-10-CM code that can be reported on claims but does not currently contribute to a Medicare Advantage member's RAF score under any CMS risk adjustment model (V28, V24, ESRD, or RxHCC). Coders reviewing H35.3123 should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H35.3123 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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