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H50.812

Billable

Duane's syndrome, left eye

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

Is H50.812 an HCC code?

No. H50.812 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

H50.812 is the ICD-10-CM diagnosis code for duane's syndrome, left eye. Duane's syndrome affecting the left eye, a condition where the eye has limited outward movement and the eye narrows when looking inward. H50.812 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).

H50.812 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; verify it is documented as such in the medical record.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H50.812 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; verify it is documented as such in the medical record
  • Confirm left eye laterality is documented; use H50.811 for right eye

Code Hierarchy

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