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H47.323 ICD-10-CM Code: Drusen of optic disc, bilateral

H47.323 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools

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Code lookupH47.323

FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of optic nerve and visual pathways (H46-H47)

H47.323

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Drusen of optic disc, bilateral

Small, yellowish deposits on the optic disc of both eyes that may be associated with vision problems or increased eye pressure.

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Inclusion Terms

Official

No inclusion terms are included in this display for H47.323. Check the code and parent instructions in the Code Book.

Excludes 2

Official
  • certain conditions originating in the perinatal period (P04-P96)Inherited from H00-H59
  • certain infectious and parasitic diseases (A00-B99)Inherited from H00-H59
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from H00-H59
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from H00-H59
  • diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)Inherited from H00-H59
  • endocrine, nutritional and metabolic diseases (E00-E88)Inherited from H00-H59
  • injury (trauma) of eye and orbit (S05.-)Inherited from H00-H59
  • injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from H00-H59
  • neoplasms (C00-D49)Inherited from H00-H59
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from H00-H59
  • syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)Inherited from H00-H59

Includes

Official

No Includes notes are included in this display for H47.323. Check the code and parent instructions in the Code Book.

Excludes 1

Official

No Excludes 1 notes are included in this display for H47.323. Check the code and parent instructions in the Code Book.

Code First

Official

No Code First sequencing instructions are included in this display for H47.323. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for H47.323. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for H47.323. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
Confirm bilateral involvement is documented; unilateral cases require H47.321 or H47.322
Document any associated symptoms or complications such as visual field defects

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 H47.323 an HCC code?

No. H47.323 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
H47.323
Description
Drusen of optic disc, 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

H47.323 is the ICD-10-CM diagnosis code for drusen of optic disc, bilateral. Small, yellowish deposits on the optic disc of both eyes that may be associated with vision problems or increased eye pressure. H47.323 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering disorders of optic nerve and visual pathways (h46-h47).

H47.323 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.

Confirm bilateral involvement is documented; unilateral cases require H47.321 or H47.322.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for H47.323 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Confirm bilateral involvement is documented; unilateral cases require H47.321 or H47.322
  • Document any associated symptoms or complications such as visual field defects

Child Codes

Code Hierarchy

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