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H43.822

Billable

Vitreomacular adhesion, left eye

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is H43.822 an HCC code?

No. H43.822 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

H43.822 is the ICD-10-CM diagnosis code for vitreomacular adhesion, left eye. Abnormal adhesion or sticking between the vitreous gel and the macula (central part of the retina) in the left eye, which can affect vision. H43.822 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).

H43.822 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.

Distinguish between adhesion (H43.82) and traction (H43.83) based on clinical findings.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H43.822 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Distinguish between adhesion (H43.82) and traction (H43.83) based on clinical findings
  • Verify left eye laterality is documented in the medical record

Code Hierarchy

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