H50.311
BillableIntermittent monocular esotropia, right eye
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H50.311 an HCC code?
No. H50.311 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
H50.311 is the ICD-10-CM diagnosis code for intermittent monocular esotropia, right eye. This condition occurs when the right eye turns inward (toward the nose) intermittently, meaning it doesn't turn in all the time. The left eye typically remains in normal position during these episodes. H50.311 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).
H50.311 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 'intermittent' (not constant) and confirms the RIGHT eye is affected to ensure accurate laterality coding.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H50.311 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation specifies 'intermittent' (not constant) and confirms the RIGHT eye is affected to ensure accurate laterality coding
- •Distinguish between monocular (one eye) and binocular esotropia, as they have different code assignments; also check if this is related to a specific cause like thyroid disease or neurological condition