Question 1

What is ICD-10 code H44.131?

Accepted Answer

H44.131 is the ICD-10-CM diagnosis code for sympathetic uveitis, right eye. Inflammation of the right eye that occurs as a reaction to injury or inflammation in the other eye. H44.131 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).

H44.131 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.

Sympathetic uveitis is a serious condition; ensure documentation includes the inciting eye and timeline of symptom onset.

Question 2

Is H44.131 an HCC code?

Accepted Answer

No. H44.131 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is H44.131 billable?

Accepted Answer

Yes. H44.131 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. H44.131 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

What is the V28 vs V24 difference for H44.131?

Accepted Answer

H44.131 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards H44.131 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

Question 5

What should coders know when reporting H44.131?

Accepted Answer

Sympathetic uveitis is a serious condition; ensure documentation includes the inciting eye and timeline of symptom onset This condition may require aggressive treatment to prevent vision loss in the sympathetic eye

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H44.131

Is H44.131 an HCC code?

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H44.131 ICD-10-CM Code: Sympathetic uveitis, right eye

HCC Buddy Code Card

H44.131

Is H44.131 an HCC code?

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Open H44.131 in the Interactive Encoder