H50.631
BillableInferior rectus muscle entrapment, right eye
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H50.631 an HCC code?
No. H50.631 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
H50.631 is the ICD-10-CM diagnosis code for inferior rectus muscle entrapment, right eye. The inferior rectus muscle in the right eye is trapped or restricted, preventing normal downward eye movement. H50.631 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).
H50.631 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 code is specific to the right eye; verify laterality in documentation before coding.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H50.631 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code is specific to the right eye; verify laterality in documentation before coding
- •Entrapment often results from trauma, surgery, or orbital conditions; review clinical notes for underlying cause