What is ICD-10 code H40.812?

H40.812 is the ICD-10-CM diagnosis code for Glaucoma with increased episcleral venous pressure, left eye. A type of glaucoma in the left eye caused by elevated pressure in the small blood vessels on the eye's surface, leading to increased intraocular pressure and potential vision loss. H40.812 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. H40.812 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. H40.812 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. H40.812 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 H40.812?

H40.812 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 H40.812 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 H40.812?

Verify left eye involvement is clearly documented in the clinical record Link to any systemic or orbital conditions that may be causing the episcleral venous pressure elevation

H40.812 ICD-10 Code: Glaucoma with increased

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupH40.812Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

H40.812

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

Glaucoma with increased episcleral venous pressure, left eye

A type of glaucoma in the left eye caused by elevated pressure in the small blood vessels on the eye's surface, leading to increased intraocular pressure and potential vision loss.

Buddy Insight

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

H40.8Other glaucoma

H40.81Glaucoma with increased episcleral venous pressure

H40.812Glaucoma with increased episcleral venous pressure, left eye

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for H40.812 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for H40.812 in this effective period.

Related Child Codes

Official

H40.811Glaucoma with increased episcleral venous pressure, right 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 H40.812 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for H40.812 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for H40.812 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for H40.812 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for H40.812 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Laterality clearly specified as left eye

Documented elevated episcleral venous pressure or clinical evidence thereof (dilated episcleral veins on examination)

Intraocular pressure measurement

Identification of the underlying cause of increased episcleral venous pressure (e.g., orbital or vascular condition)

MEAT Support

HCC Buddy guidance

Laterality clearly specified as left eye

Documented elevated episcleral venous pressure or clinical evidence thereof (dilated episcleral veins on examination)

Intraocular pressure measurement

Identification of the underlying cause of increased episcleral venous pressure (e.g., orbital or vascular condition)

Audit Caution

HCC Buddy guidance

Coding as primary open-angle glaucoma when the underlying cause is elevated episcleral venous pressure — this is a secondary glaucoma

Failing to code the underlying vascular or orbital condition that causes the increased episcleral venous pressure

Using unspecified glaucoma (H40.9) when the specific type is documented

Omitting laterality when it is clearly documented in the clinical record

Common Mistakes

HCC Buddy guidance

H40.10-H40.14 — Open-angle glaucoma, unspecified or by stage (does not specify the secondary etiology)

H40.50-H40.53 — Secondary glaucoma due to other eye diseases (different underlying mechanism)

H40.60-H40.63 — Secondary glaucoma due to drugs (medication-induced, not vascular)

H40.89 — Other specified glaucoma (less specific; use H40.81x when episcleral venous pressure is the identified cause)

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 H40.812 an HCC code?

No. H40.812 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 H40.812

For H40.812to 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 H40.812 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

H40.812 is the ICD-10-CM diagnosis code for glaucoma with increased episcleral venous pressure, left eye. A type of glaucoma in the left eye caused by elevated pressure in the small blood vessels on the eye's surface, leading to increased intraocular pressure and potential vision loss. H40.812 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering glaucoma (h40-h42).

H40.812 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. No mapping exists under CMS-HCC v28, v24, or ESRD models. The RxHCC classification captures the pharmacy cost implications of ongoing glaucoma treatment. No hierarchies apply for this code.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H40.812 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify left eye involvement is clearly documented in the clinical record
•Link to any systemic or orbital conditions that may be causing the episcleral venous pressure elevation

Clinical Significance

Glaucoma with increased episcleral venous pressure is a secondary glaucoma caused by elevated venous pressure in the episcleral veins, leading to impaired aqueous humor outflow and increased intraocular pressure. This can result from conditions such as carotid-cavernous fistula, Sturge-Weber syndrome, or superior vena cava syndrome. Identifying the underlying cause is critical for appropriate management and risk stratification.

Documentation Requirements

✓Laterality clearly specified as left eye
✓Documented elevated episcleral venous pressure or clinical evidence thereof (dilated episcleral veins on examination)
✓Intraocular pressure measurement
✓Identification of the underlying cause of increased episcleral venous pressure (e.g., orbital or vascular condition)
✓Optic nerve assessment including cup-to-disc ratio
✓Visual field testing results if available
✓Current treatment plan and monitoring schedule

Commonly Confused Codes

•H40.10-H40.14: Open-angle glaucoma, unspecified or by stage (does not specify the secondary etiology)
•H40.50-H40.53: Secondary glaucoma due to other eye diseases (different underlying mechanism)
•H40.60-H40.63: Secondary glaucoma due to drugs (medication-induced, not vascular)
•H40.89: Other specified glaucoma (less specific; use H40.81x when episcleral venous pressure is the identified cause)