H43.89 ICD-10-CM Code: Other disorders of vitreous body
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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of vitreous body and globe (H43-H44)
H43.89
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther disorders of vitreous body
This code describes various disorders affecting the vitreous body (the clear gel inside the eye) that are not classified elsewhere, such as vitreous opacities, vitreous membranes, or other structural abnormalities of the vitreous. These conditions can affect vision and may require ophthalmologic evaluation and treatment.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
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Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for H43.89 in this effective period.
Excludes 2
Official- vitreous abscess (H44.02-)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H43.89 in this effective period.
Excludes 1
Official- proliferative vitreo-retinopathy with retinal detachment (H33.4-)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H43.89 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H43.89 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H43.89 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is H43.89 an HCC code?
No. H43.89 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
H43.89 is the ICD-10-CM diagnosis code for other disorders of vitreous body. This code describes various disorders affecting the vitreous body (the clear gel inside the eye) that are not classified elsewhere, such as vitreous opacities, vitreous membranes, or other structural abnormalities of the vitreous. These conditions can affect vision and may require ophthalmologic evaluation and treatment. H43.89 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).
H43.89 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.
Use this code only when the specific vitreous disorder does not have its own dedicated ICD-10-CM code; always check for more specific codes first (such as H43.81 for vitreous degeneration or H43.82 for vitreous hemorrhage).
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H43.89 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when the specific vitreous disorder does not have its own dedicated ICD-10-CM code; always check for more specific codes first (such as H43.81 for vitreous degeneration or H43.82 for vitreous hemorrhage)
- •Documentation should clearly describe the nature of the vitreous disorder to support medical necessity and ensure appropriate reimbursement; consider requesting clarification from the provider if the documentation is vague