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H40.239

Billable

Intermittent angle-closure glaucoma, unspecified eye

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

Is H40.239 an HCC code?

No. H40.239 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 244Other Non-Acute Glaucoma
0.067

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 H40.239

For H40.239to 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 H40.239 during that encounter — not just copy-forwarded from a problem list.

What This Code Means

H40.239 is the ICD-10-CM diagnosis code for intermittent angle-closure glaucoma, unspecified eye. A recurring form of glaucoma where the drainage angle periodically closes, causing temporary increases in eye pressure, but the specific eye or eyes affected are not documented. H40.239 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering glaucoma (h40-h42).

H40.239 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, H40.239 maps to RxHCC 244 (Glaucoma, Other) with a RAF weight of 0.0. No V28, V24, or ESRD HCC mappings exist. The HCC mapping is identical to laterality-specific codes. While risk adjustment value is unchanged, unspecified laterality increases audit vulnerability and may indicate documentation quality concerns that affect overall coding accuracy metrics.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H40.239 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 eye laterality cannot be determined from documentation
  • Query the provider to determine if the condition is unilateral or bilateral for more specific coding

Clinical Significance

Intermittent angle-closure glaucoma, unspecified eye is the least specific code for intermittent angle-closure glaucoma, used only when laterality cannot be determined from the documentation. This code should rarely be necessary in practice since gonioscopy inherently documents which eye(s) are examined and affected. It represents a documentation improvement opportunity.

Documentation Requirements

  • Documentation of intermittent angle-closure glaucoma without laterality specification
  • Gonioscopy findings confirming angle closure (even if laterality not specified in the record)
  • Clinical rationale for why laterality cannot be determined
  • Query to the examining ophthalmologist for laterality clarification
  • Treatment plan for the angle-closure condition

Commonly Confused Codes

  • H40.231-H40.233 — Laterality-specific intermittent angle-closure glaucoma: always preferred when laterality is documented
  • H40.9 — Unspecified glaucoma: even less specific, does not capture the angle-closure type
  • H40.159 — Residual stage of open-angle glaucoma, unspecified eye: different glaucoma type and stage
  • H40.00X0 — Preglaucoma, unspecified, unspecified eye: suspect status, not confirmed glaucoma

Code Hierarchy

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H40.239 ICD-10 Code: Intermittent angle-closure | HCC Buddy