H43.21
BillableCrystalline deposits in vitreous body, right eye
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H43.21 an HCC code?
No. H43.21 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
H43.21 is the ICD-10-CM diagnosis code for crystalline deposits in vitreous body, right eye. Crystal-like deposits have formed in the clear gel inside the right eye, which may affect vision clarity. H43.21 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering disorders of vitreous body and globe (h43-h44).
H43.21 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.
Verify right eye is documented; check for associated uveitis, infection, or metabolic disease.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H43.21 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify right eye is documented; check for associated uveitis, infection, or metabolic disease
- •Specify type of crystalline deposits if documented (e.g., cholesterol, calcium, inflammatory)