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H40.81 ICD-10-CM Code: Glaucoma with increased episcleral venous pressure

H40.81 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · free HCC coding tools

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

H40.81

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Glaucoma with increased episcleral venous pressure

Glaucoma with increased episcleral venous pressure

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
H40Glaucoma
H40.8Other glaucoma
H40.81Glaucoma with increased episcleral venous pressure

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H40.81 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H40.81 in this effective period.

Related Child Codes

Official
H40.811Glaucoma with increased episcleral venous pressure, right eye
H40.812Glaucoma with increased episcleral venous pressure, left eye
H40.813Glaucoma with increased episcleral venous pressure, bilateral
H40.819Glaucoma with increased episcleral venous pressure, unspecified eye

Includes

Official

ICD-10-CM does not list Includes notes for H40.81 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for H40.81 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H40.81 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H40.81 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H40.81 in this effective period.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Code
H40.81
Description
Glaucoma with increased episcleral venous pressure
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

H40.81 is the ICD-10-CM diagnosis code for glaucoma with increased episcleral venous pressure. H40.81 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering glaucoma (h40-h42).

Header codes like H40.81 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at H40.81's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H40.81 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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