H40.231
BillableIntermittent angle-closure glaucoma, right eye
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H40.231 an HCC code?
No. H40.231 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
HCC Category Mapping
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 H40.231
For H40.231to 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 H40.231 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
H40.231 is the ICD-10-CM diagnosis code for intermittent angle-closure glaucoma, right eye. A recurring form of glaucoma in the right eye where the drainage angle periodically closes, causing temporary increases in eye pressure. H40.231 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering glaucoma (h40-h42).
H40.231 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, H40.231 maps to RxHCC 244 (Glaucoma, Other) with a RAF weight of 0.0. No V28, V24, or ESRD HCC mappings exist. The RxHCC mapping captures the medication management requirements for angle-closure glaucoma, which may differ from open-angle treatment regimens. The distinction between RxHCC 243 (Glaucoma) and 244 (Glaucoma, Other) affects medication cost predictions.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H40.231 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Distinguish this from acute angle-closure glaucoma; intermittent episodes may resolve spontaneously or with treatment
- •Document the frequency and severity of episodes to support medical necessity for ongoing management
Clinical Significance
Intermittent angle-closure glaucoma of the right eye is a form of glaucoma where the drainage angle periodically closes, causing episodic elevation of intraocular pressure. Between episodes, the angle may appear open. This condition carries risk of acute angle-closure crisis, which is an ophthalmic emergency. Identification and prophylactic treatment (typically laser peripheral iridotomy) are essential to prevent permanent vision loss.
Documentation Requirements
- ✓Gonioscopy findings documenting intermittent angle closure in the right eye
- ✓Intraocular pressure measurements including during and between episodes
- ✓Documentation of episodic symptoms (halos, blurred vision, eye pain)
- ✓Optic nerve assessment and visual field testing
- ✓Treatment plan including prophylactic laser peripheral iridotomy status
Commonly Confused Codes
- •H40.211 — Acute angle-closure glaucoma, right eye: acute crisis with sustained angle closure, more urgent
- •H40.221 — Chronic angle-closure glaucoma, right eye: persistent angle closure, not intermittent
- •H40.1111 — Primary open-angle glaucoma, right eye, mild stage: different mechanism, open angles
- •H40.031 — Anatomical narrow angle, right eye: narrow angles without actual closure or pressure elevation