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H40.023

Billable

Open angle with borderline findings, high risk, bilateral

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is H40.023 an HCC code?

No. H40.023 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

H40.023 is the ICD-10-CM diagnosis code for open angle with borderline findings, high risk, bilateral. A condition where both eyes have open drainage angles but show borderline signs of glaucoma with high risk of vision loss. H40.023 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering glaucoma (h40-h42).

H40.023 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 bilateral code only when both eyes are documented as having high-risk borderline findings.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H40.023 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use bilateral code only when both eyes are documented as having high-risk borderline findings
  • Do not use this code if only one eye is affected; use the appropriate unilateral code instead

Code Hierarchy

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