H50.659
BillableMedial rectus muscle entrapment, unspecified eye
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is H50.659 an HCC code?
No. H50.659 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
H50.659 is the ICD-10-CM diagnosis code for medial rectus muscle entrapment, unspecified eye. The medial rectus muscle is trapped or restricted, but the specific eye is not documented. H50.659 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).
H50.659 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.
Use this code only when laterality cannot be determined from available documentation.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H50.659 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when laterality cannot be determined from available documentation
- •Query the provider to obtain specific eye identification when feasible