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H50.641

Billable

Lateral 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 H50.641 an HCC code?

No. H50.641 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

H50.641 is the ICD-10-CM diagnosis code for lateral rectus muscle entrapment, right eye. The lateral rectus muscle in the right eye is trapped or restricted, preventing normal outward eye movement. H50.641 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).

H50.641 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.

Lateral rectus entrapment commonly occurs with orbital fractures; check for associated fracture codes.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H50.641 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Lateral rectus entrapment commonly occurs with orbital fractures; check for associated fracture codes
  • Verify right eye is documented; this code is laterality-specific

Code Hierarchy

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