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.

Which HCC does H40.812 map to under V28?

H40.812 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

What RAF reference is published for H40.812?

H40.812 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

What is the V28 vs V24 difference for H40.812?

H40.812 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

What documentation supports 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 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

2026 ICD-10-CM H40.812: Glaucoma with increased episcleral

H40.812 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software

ICD-10-CM Code View

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Code lookupH40.812

Effective 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

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

Mapped

HCC 244

Other Non-Acute Glaucoma

Code-level coefficient reference

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

No inclusion terms are included in this display for H40.812. Check the code and parent instructions in the Code Book.

Excludes 2

Official

certain conditions originating in the perinatal period (P04-P96)Inherited from H00-H59
certain infectious and parasitic diseases (A00-B99)Inherited from H00-H59
complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from H00-H59
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from H00-H59
diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)Inherited from H00-H59
endocrine, nutritional and metabolic diseases (E00-E88)Inherited from H00-H59
injury (trauma) of eye and orbit (S05.-)Inherited from H00-H59
injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from H00-H59
neoplasms (C00-D49)Inherited from H00-H59
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from H00-H59
syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)Inherited from H00-H59

Related 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

No Includes notes are included in this display for H40.812. Check the code and parent instructions in the Code Book.

Excludes 1

Official

absolute glaucoma (H44.51-)Inherited from H40
congenital glaucoma (Q15.0)Inherited from H40
traumatic glaucoma due to birth injury (P15.3)Inherited from H40

Code First

Official

No Code First sequencing instructions are included in this display for H40.812. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for H40.812. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for H40.812. Check the code and parent instructions in the Code Book.

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)

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 →

Is H40.812 an HCC code?

H40.812 is not in the CMS-HCC V28 or V24 community payment model. H40.812 has a separate mapping under the Part D RxHCC model (HCC 244 (Other Non-Acute Glaucoma)); the applicable result needs member context.

Code: H40.812
Description: Glaucoma with increased episcleral venous pressure, left eye
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

RxHCCHCC 244, Other Non-Acute Glaucoma

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work H40.812 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for H40.812

For H40.812, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

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

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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 has no mapping under the CMS-HCC V28 or V24 community payment models. H40.812 has a separate mapping under the Part D RxHCC model (HCC 244 (Other Non-Acute Glaucoma)); the applicable result needs member context. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.

Verify left eye involvement is clearly documented in the clinical record.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, 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)