H50.811 ICD-10-CM Code: Duane's syndrome, right eye
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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of ocular muscles, binocular movement, accommodation and refraction (H49-H52)
H50.811
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceDuane's syndrome, right eye
Duane's syndrome is a rare eye movement disorder where the affected eye has limited ability to move outward (away from the nose) and the eye may turn inward when looking to the side. This code specifically indicates the condition affects the right eye.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
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Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for H50.811 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H50.811 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H50.811 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H50.811 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H50.811 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H50.811 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H50.811 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is H50.811 an HCC code?
No. H50.811 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
H50.811 is the ICD-10-CM diagnosis code for duane's syndrome, right eye. Duane's syndrome is a rare eye movement disorder where the affected eye has limited ability to move outward (away from the nose) and the eye may turn inward when looking to the side. This code specifically indicates the condition affects the right eye. H50.811 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).
H50.811 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.
Duane's syndrome is a congenital condition, so verify documentation confirms this is a congenital eye movement disorder rather than an acquired condition.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H50.811 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Duane's syndrome is a congenital condition, so verify documentation confirms this is a congenital eye movement disorder rather than an acquired condition
- •If the condition affects both eyes, code both H50.811 (right eye) and H50.812 (left eye) separately rather than using a bilateral code