H35.462
BillableSecondary vitreoretinal degeneration, left eye
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H35.462 an HCC code?
No. H35.462 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
H35.462 is the ICD-10-CM diagnosis code for secondary vitreoretinal degeneration, left eye. Deterioration of the light-sensitive tissue at the back of the left eye (retina) and the gel-like substance filling the eye (vitreous) that has developed as a result of another eye condition or disease. H35.462 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).
H35.462 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.
This code requires documentation of the underlying cause or primary condition that led to the secondary degeneration.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H35.462 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code requires documentation of the underlying cause or primary condition that led to the secondary degeneration
- •Ensure laterality is correctly documented as left eye; do not use this code for bilateral or unspecified cases