H50.16 ICD-10-CM Code: Alternating exotropia with A pattern
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of ocular muscles, binocular movement, accommodation and refraction (H49-H52)
H50.16
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAlternating exotropia with A pattern
This is a condition where the eyes turn outward alternately (one eye turns out while the other focuses), and the outward turning is more pronounced when looking downward than upward. It's a type of eye misalignment that affects how the eyes work together.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
Official- Divergent concomitant strabismus
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H50.16 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H50.16 in this effective period.
Excludes 1
Official- intermittent exotropia (H50.33-, H50.34)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H50.16 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H50.16 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H50.16 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is H50.16 an HCC code?
No. H50.16 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
H50.16 is the ICD-10-CM diagnosis code for alternating exotropia with a pattern. This is a condition where the eyes turn outward alternately (one eye turns out while the other focuses), and the outward turning is more pronounced when looking downward than upward. It's a type of eye misalignment that affects how the eyes work together. H50.16 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering disorders of ocular muscles, binocular movement, accommodation and refraction (h49-h52).
H50.16 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.
Verify documentation specifies 'alternating exotropia' and 'A pattern' - the A pattern indicates the horizontal deviation changes with vertical gaze direction.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H50.16 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation specifies 'alternating exotropia' and 'A pattern' - the A pattern indicates the horizontal deviation changes with vertical gaze direction
- •Confirm laterality if documented (right eye, left eye, or bilateral) and ensure the code reflects the correct eye involvement, as some H50 codes require laterality specification