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H50.331

Billable

Intermittent monocular exotropia, right eye

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is H50.331 an HCC code?

No. H50.331 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

H50.331 is the ICD-10-CM diagnosis code for intermittent monocular exotropia, right eye. A condition where the right eye occasionally turns outward away from the nose, while the left eye remains straight. This intermittent eye misalignment typically occurs during certain activities or when the person is tired. H50.331 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).

H50.331 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 'right eye' and 'intermittent' to distinguish from constant exotropia.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H50.331 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Verify documentation specifies 'right eye' and 'intermittent' to distinguish from constant exotropia
  • Confirm this is monocular (one eye affected) rather than alternating exotropia

Code Hierarchy

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