H40.001
BillablePreglaucoma, unspecified, right eye
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H40.001 an HCC code?
No. H40.001 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
H40.001 is the ICD-10-CM diagnosis code for preglaucoma, unspecified, right eye. This code describes a condition where a patient has risk factors or signs that suggest glaucoma may develop in the future, but the disease has not yet been diagnosed in the right eye. It indicates the eye is being monitored for potential glaucoma development. H40.001 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering glaucoma (h40-h42).
H40.001 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.
Verify documentation specifies 'right eye' before assigning this code; if both eyes are affected, use bilateral code H40.003 instead.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H40.001 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.