H43.312
BillableVitreous membranes and strands, left eye
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H43.312 an HCC code?
No. H43.312 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
H43.312 is the ICD-10-CM diagnosis code for vitreous membranes and strands, left eye. Thin membranes or string-like strands that form in the clear gel of the left eye, which may cause floaters or vision obstruction. H43.312 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).
H43.312 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.
Confirm left eye laterality in documentation to avoid miscoding as right eye (H43.311).
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H43.312 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm left eye laterality in documentation to avoid miscoding as right eye (H43.311)
- •Consider documenting whether strands are causing visual symptoms or are incidental findings