What is ICD-10 code H40.249?

H40.249 is the ICD-10-CM diagnosis code for Residual stage of angle-closure glaucoma, unspecified eye. It belongs to the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59). H40.249 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. H40.249 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. H40.249 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. H40.249 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 H40.249?

H40.249 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 H40.249 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 H40.249?

Always verify the laterality in the medical record and use the appropriate 5th character (1=right eye, 2=left eye, 3=bilateral, 9=unspecified) rather than defaulting to unspecified when documentation is available Ensure the diagnosis clearly documents 'residual stage' rather than acute or intermittent angle-closure glaucoma, as this indicates chronic sequelae from a previous acute episode

H40.249: Residual stage of angle-closure glaucoma, unspecified eye — ICD-10

ICD-10-CM Code View

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Code lookupH40.249Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

H40.249

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

Residual stage of angle-closure glaucoma, unspecified eye

This code describes the final stage of angle-closure glaucoma after the acute attack has resolved, where the eye has sustained permanent damage from the previous episode of elevated eye pressure. The condition affects an unspecified eye (meaning the documentation doesn't specify left, right, or bilateral).

Buddy Insight

Residual stage angle-closure glaucoma indicates permanent structural damage remaining after an acute or chronic angle-closure episode has resolved.

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 244

Glaucoma, Other

RAF 0.0

Code Trumping

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Code Book Path

Official

H40.2Primary angle-closure glaucoma

H40.24Residual stage of angle-closure glaucoma

H40.249Residual stage of angle-closure glaucoma, unspecified eye

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H40.249 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H40.249 in this effective period.

Related Child Codes

Official

H40.241Residual stage of angle-closure glaucoma, right eye

H40.242Residual stage of angle-closure glaucoma, left eye

H40.243Residual stage of angle-closure glaucoma, bilateral

Includes

Official

ICD-10-CM does not list Includes notes for H40.249 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for H40.249 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H40.249 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H40.249 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H40.249 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documented history of prior angle-closure glaucoma episode (acute, subacute, or chronic)

Laterality clearly specified as unspecified eye in the clinical note

Gonioscopy or anterior segment imaging confirming residual angle changes

Current intraocular pressure (IOP) measurement

MEAT Support

HCC Buddy guidance

Documented history of prior angle-closure glaucoma episode (acute, subacute, or chronic)

Laterality clearly specified as unspecified eye in the clinical note

Gonioscopy or anterior segment imaging confirming residual angle changes

Current intraocular pressure (IOP) measurement

Audit Caution

HCC Buddy guidance

Coding residual stage when the angle-closure episode is still active — residual stage means the acute/chronic phase has fully resolved

Failing to document laterality, which is required for accurate code assignment at the 6th character level

Using unspecified eye (H40.249) when laterality is documented in the record — always code to the highest specificity

Not distinguishing between residual damage from angle closure versus new or concurrent open-angle glaucoma

Common Mistakes

HCC Buddy guidance

H40.211-H40.219 — Acute angle-closure glaucoma (use when the acute episode is currently active, not resolved)

H40.221-H40.229 — Chronic angle-closure glaucoma (use when angle closure is ongoing, not yet in residual stage)

H40.231-H40.239 — Intermittent angle-closure glaucoma (use for episodic angle closure that recurs)

H40.10-H40.14 — Open-angle glaucoma (different mechanism; angle is open, not closed)

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 H40.249 an HCC code?

No. H40.249 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 244, Glaucoma, Other

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 H40.249

For H40.249to 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 H40.249 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

H40.249 is the ICD-10-CM diagnosis code for residual stage of angle-closure glaucoma, unspecified eye. This code describes the final stage of angle-closure glaucoma after the acute attack has resolved, where the eye has sustained permanent damage from the previous episode of elevated eye pressure. The condition affects an unspecified eye (meaning the documentation doesn't specify left, right, or bilateral). H40.249 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering glaucoma (h40-h42).

H40.249 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.

Maps to RxHCC 244 (Glaucoma, Other) with a RAF weight of 0.000 in the prescription drug model. This code does not map to any CMS-HCC under v28 or v24 models. While the RxHCC mapping carries no incremental RAF weight, it is relevant for pharmacy risk adjustment and may influence prescription drug plan cost predictions. No hierarchies apply within the CMS-HCC models for this code.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H40.249 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Always verify the laterality in the medical record and use the appropriate 5th character (1=right eye, 2=left eye, 3=bilateral, 9=unspecified) rather than defaulting to unspecified when documentation is available
•Ensure the diagnosis clearly documents 'residual stage' rather than acute or intermittent angle-closure glaucoma, as this indicates chronic sequelae from a previous acute episode

Clinical Significance

Residual stage angle-closure glaucoma indicates permanent structural damage remaining after an acute or chronic angle-closure episode has resolved. This diagnosis captures the long-term sequelae of angle closure, which may include peripheral anterior synechiae, optic nerve damage, and irreversible vision loss. Accurate coding ensures ongoing monitoring and treatment needs are reflected in the patient's risk profile.

Documentation Requirements

✓Documented history of prior angle-closure glaucoma episode (acute, subacute, or chronic)
✓Laterality clearly specified as unspecified eye in the clinical note
✓Gonioscopy or anterior segment imaging confirming residual angle changes
✓Current intraocular pressure (IOP) measurement
✓Description of residual structural damage (e.g., peripheral anterior synechiae, optic disc changes, visual field deficits)
✓Current treatment plan including any ongoing medications or monitoring schedule

Commonly Confused Codes

•H40.211-H40.219: Acute angle-closure glaucoma (use when the acute episode is currently active, not resolved)
•H40.221-H40.229: Chronic angle-closure glaucoma (use when angle closure is ongoing, not yet in residual stage)
•H40.231-H40.239: Intermittent angle-closure glaucoma (use for episodic angle closure that recurs)
•H40.10-H40.14: Open-angle glaucoma (different mechanism; angle is open, not closed)
•H42: Glaucoma in diseases classified elsewhere (use when glaucoma is secondary to a systemic condition)