H43.392 ICD-10-CM Code: Other vitreous opacities, left eye
HCC Buddy Code Card
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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of vitreous body and globe (H43-H44)
H43.392
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther vitreous opacities, left eye
Various types of cloudiness or opaque material in the clear gel of the left eye that are not otherwise specified.
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
Inclusion Terms
Official- Vitreous floaters
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H43.392 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H43.392 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H43.392 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H43.392 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H43.392 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H43.392 in this effective period.
Buddy Documentation Tip
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 H43.392 an HCC code?
No. H43.392 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- H43.392
- Description
- Other vitreous opacities, left eye
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
H43.392 is the ICD-10-CM diagnosis code for other vitreous opacities, left eye. Various types of cloudiness or opaque material in the clear gel of the left eye that are not otherwise specified. H43.392 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).
H43.392 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 left eye laterality in the medical record to prevent miscoding as right eye.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H43.392 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify left eye laterality in the medical record to prevent miscoding as right eye
- •Consider whether the opacity is acute (post-hemorrhage) or chronic (degenerative) to guide clinical management documentation