Question 1

What is ICD-10 code H44.2A9?

Accepted Answer

H44.2A9 is the ICD-10-CM diagnosis code for degenerative myopia with choroidal neovascularization, unspecified eye. A severe form of progressive nearsightedness where abnormal blood vessel growth occurs under the retina, but the affected eye is not specified. H44.2A9 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).

H44.2A9 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 only when laterality cannot be determined from the medical record.

Question 2

Is H44.2A9 an HCC code?

Accepted Answer

No. H44.2A9 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 H44.2A9 billable?

Accepted Answer

Yes. H44.2A9 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. H44.2A9 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

Which HCC does H44.2A9 map to under V28?

Accepted Answer

H44.2A9 does not map to a CMS-HCC V28 payment category. Check the current CMS-HCC V28 model file for payment year 2026 rather than an older V24 tip sheet.

Question 5

What does H44.2A9 pay in RAF?

Accepted Answer

H44.2A9 has no separately stated V28 community RAF weight. If it is not a V28 payment HCC, it adds nothing to a community RAF score.

Question 6

What is the V28 vs V24 difference for H44.2A9?

Accepted Answer

H44.2A9 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 community model rewards H44.2A9 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's V28/V24 community RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a community payment HCC.

Question 7

What documentation supports H44.2A9?

Accepted Answer

Use only when laterality cannot be determined from the medical record Query the provider if eye involvement is not documented to assign the more specific laterality codes H44.2A9 is not a CMS-HCC payment code, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

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H44.2A9

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H44.2A9 ICD-10-CM Code: Degenerative myopia with choroidal neovascularization, unspecified eye

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H44.2A9

Is H44.2A9 an HCC code?

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What This Code Means

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H44.2A9 code history

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