H43.392
BillableOther vitreous opacities, left eye
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
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.
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