What is ICD-10 code H40.151?

H40.151 is the ICD-10-CM diagnosis code for Residual stage of open-angle glaucoma, right eye. The final stage of open-angle glaucoma in the right eye, where significant vision loss has already occurred and the condition has stabilized. H40.151 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. H40.151 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. H40.151 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. H40.151 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for H40.151?

H40.151 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards H40.151 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

What should coders know when reporting H40.151?

Use this code only when documentation confirms the residual stage, not earlier stages of open-angle glaucoma Ensure laterality is clearly documented; this code is specific to the right eye only

H40.151 ICD-10 Code: Residual stage of open-angle

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupH40.151Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Glaucoma (H40-H42)

H40.151

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

Residual stage of open-angle glaucoma, right eye

The final stage of open-angle glaucoma in the right eye, where significant vision loss has already occurred and the condition has stabilized.

Buddy Insight

Residual stage of open-angle glaucoma in the right eye indicates that the glaucomatous disease process has been controlled or arrested but residual optic nerve damage and visual field loss persist.

CMS-HCC V28

Not risk-adjusted for this model/period.

RAF 0

CMS-HCC V24

Not risk-adjusted for this model/period.

RAF 0

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Not risk-adjusted for this model/period.

RAF 0

RXHCC

Mapped

HCC 243

Glaucoma

RAF 0.0

Code Trumping

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Code Book Path

Official

H40.1Open-angle glaucoma

H40.15Residual stage of open-angle glaucoma

H40.151Residual stage of open-angle glaucoma, right eye

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H40.151 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H40.151 in this effective period.

Related Child Codes

Official

H40.152Residual stage of open-angle glaucoma, left eye

H40.153Residual stage of open-angle glaucoma, bilateral

H40.159Residual stage of open-angle glaucoma, unspecified eye

Includes

Official

ICD-10-CM does not list Includes notes for H40.151 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for H40.151 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H40.151 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H40.151 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H40.151 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documented history of open-angle glaucoma in the right eye with current residual damage

Intraocular pressure measurements showing current control

Optic nerve assessment documenting permanent cupping or damage

Visual field testing showing residual field loss

MEAT Support

HCC Buddy guidance

Documented history of open-angle glaucoma in the right eye with current residual damage

Intraocular pressure measurements showing current control

Optic nerve assessment documenting permanent cupping or damage

Visual field testing showing residual field loss

Audit Caution

HCC Buddy guidance

Confusing residual stage with mild, moderate, severe, or indeterminate stages of active disease

Using active glaucoma codes when the disease process is controlled with only residual damage remaining

Not specifying the residual stage when documentation indicates the disease is arrested with permanent damage

Incorrectly coding as glaucoma suspect when permanent damage from prior glaucoma is documented

Common Mistakes

HCC Buddy guidance

H40.1111 — Primary open-angle glaucoma, right eye, mild stage: active disease, not residual

H40.152 — Residual stage of open-angle glaucoma, left eye: contralateral side

H40.10X1 — Unspecified open-angle glaucoma, right eye: does not specify the residual stage

H40.159 — Residual stage of open-angle glaucoma, unspecified eye: less specific laterality

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 H40.151 an HCC code?

No. H40.151 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

HCC Category Mapping

RxHCCHCC 243, Glaucoma

0.000

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 H40.151

For H40.151to 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 H40.151 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

H40.151 is the ICD-10-CM diagnosis code for residual stage of open-angle glaucoma, right eye. The final stage of open-angle glaucoma in the right eye, where significant vision loss has already occurred and the condition has stabilized. H40.151 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering glaucoma (h40-h42).

H40.151 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.

In the RxHCC model, H40.151 maps to RxHCC 243 (Glaucoma) with a RAF weight of 0.0. This code does not map to V28, V24, or ESRD HCCs. The RxHCC mapping reflects ongoing medication management needs for glaucoma. The primary risk adjustment impact is through the RxHCC model's recognition of chronic ophthalmic medication use.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H40.151 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code only when documentation confirms the residual stage, not earlier stages of open-angle glaucoma
•Ensure laterality is clearly documented; this code is specific to the right eye only

Clinical Significance

Residual stage of open-angle glaucoma in the right eye indicates that the glaucomatous disease process has been controlled or arrested but residual optic nerve damage and visual field loss persist. This stage reflects the permanent nature of glaucoma damage — while intraocular pressure may be normalized through treatment, the structural and functional damage remains. Ongoing monitoring is required to detect any reactivation of the disease process.

Documentation Requirements

✓Documented history of open-angle glaucoma in the right eye with current residual damage
✓Intraocular pressure measurements showing current control
✓Optic nerve assessment documenting permanent cupping or damage
✓Visual field testing showing residual field loss
✓Current treatment regimen (medications, prior surgical interventions) and monitoring plan

Commonly Confused Codes

•H40.1111: Primary open-angle glaucoma, right eye, mild stage: active disease, not residual
•H40.152: Residual stage of open-angle glaucoma, left eye: contralateral side
•H40.10X1: Unspecified open-angle glaucoma, right eye: does not specify the residual stage
•H40.159: Residual stage of open-angle glaucoma, unspecified eye: less specific laterality