H40.233
BillableIntermittent angle-closure glaucoma, bilateral
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H40.233 an HCC code?
No. H40.233 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 H40.233
For H40.233to 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 H40.233 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
H40.233 is the ICD-10-CM diagnosis code for intermittent angle-closure glaucoma, bilateral. A recurring form of glaucoma affecting both eyes where the drainage angle periodically closes in each eye, causing temporary increases in eye pressure. H40.233 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering glaucoma (h40-h42).
H40.233 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, H40.233 maps to RxHCC 244 (Glaucoma, Other) with a RAF weight of 0.0. No V28, V24, or ESRD HCC mappings exist. Bilateral designation does not increase the HCC weight compared to unilateral codes, but it accurately reflects the scope of disease and bilateral medication management needs captured by the RxHCC model.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H40.233 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 bilateral intermittent angle-closure episodes
- •Distinguish from acute angle-closure; document whether episodes are occurring simultaneously or independently in each eye
Clinical Significance
Intermittent angle-closure glaucoma, bilateral indicates that both eyes experience periodic angle closure with episodic intraocular pressure elevation. Bilateral involvement is common since the anatomical predisposition (shallow anterior chamber, thick lens, short axial length) typically affects both eyes. Bilateral prophylactic treatment is typically recommended, and these patients require vigilant monitoring for acute angle-closure crisis in either eye.
Documentation Requirements
- ✓Bilateral gonioscopy documenting intermittent angle closure in both eyes
- ✓Bilateral intraocular pressure measurements
- ✓Bilateral optic nerve and visual field assessment
- ✓Documentation of anatomical risk factors (shallow anterior chamber, hyperopia)
- ✓Bilateral treatment plan including laser peripheral iridotomy status for both eyes
Commonly Confused Codes
- •H40.231/H40.232 — Intermittent angle-closure glaucoma, right/left eye: use when only one eye is affected
- •H40.223 — Chronic angle-closure glaucoma, bilateral: persistent rather than intermittent closure
- •H40.213 — Acute angle-closure glaucoma, bilateral: acute crisis in both eyes simultaneously (rare)
- •H40.239 — Intermittent angle-closure glaucoma, unspecified eye: less specific, use only when laterality unknown