H44.423 ICD-10-CM Code: Hypotony of eye due to ocular fistula, bilateral
H44.423 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of vitreous body and globe (H43-H44)
H44.423
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceHypotony of eye due to ocular fistula, bilateral
Abnormally low pressure in both eyes caused by abnormal openings or connections (fistulas) in the eyes that allow fluid to leak out.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for H44.423 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H44.423 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H44.423 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H44.423 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H44.423 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H44.423 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H44.423 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is H44.423 an HCC code?
No. H44.423 is a billable ICD-10-CM code with no mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- H44.423
- Description
- Hypotony of eye due to ocular fistula, bilateral
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
H44.423 is the ICD-10-CM diagnosis code for hypotony of eye due to ocular fistula, bilateral. Abnormally low pressure in both eyes caused by abnormal openings or connections (fistulas) in the eyes that allow fluid to leak out. H44.423 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).
H44.423 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.
Use only when fistulas are documented in both eyes.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for H44.423 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use only when fistulas are documented in both eyes
- •Confirm bilateral involvement is explicitly stated in the medical record