Question 1

What is ICD-10 code H47.391?

Accepted Answer

H47.391 is the ICD-10-CM diagnosis code for other disorders of optic disc, right eye. Various other abnormalities or disorders affecting the optic disc in the right eye that are not classified elsewhere. These may include structural changes or other disc-related conditions. H47.391 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).

H47.391 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.

This is a catch-all code for optic disc disorders not specifically classified; ensure the condition does not fit a more specific code.

Question 2

Is H47.391 an HCC code?

Accepted Answer

No. H47.391 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 H47.391 billable?

Accepted Answer

Yes. H47.391 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. H47.391 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 H47.391 map to under V28?

Accepted Answer

H47.391 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 H47.391 pay in RAF?

Accepted Answer

H47.391 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 H47.391?

Accepted Answer

H47.391 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 H47.391 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 H47.391?

Accepted Answer

This is a catch-all code for optic disc disorders not specifically classified; ensure the condition does not fit a more specific code Document the specific nature of the disc disorder in the medical record for clarity H47.391 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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H47.391

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H47.391 ICD-10-CM Code: Other disorders of optic disc, right eye

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H47.391

Is H47.391 an HCC code?

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Work H47.391 in HCC Buddy