H53.031 ICD-10-CM Code: Strabismic amblyopia, right eye
H53.031 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Visual disturbances and blindness (H53-H54)
H53.031
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceStrabismic amblyopia, right eye
Strabismic amblyopia of the right eye develops when the right eye turns inward, outward, upward, or downward, causing the brain to suppress its image and rely on the other eye, resulting in poor vision development.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for H53.031 in this effective period.
Excludes 2
Official- strabismus (H50.-)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H53.031 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H53.031 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H53.031 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H53.031 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H53.031 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is H53.031 an HCC code?
No. H53.031 is a billable ICD-10-CM code with no mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- H53.031
- Description
- Strabismic amblyopia, right eye
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
H53.031 is the ICD-10-CM diagnosis code for strabismic amblyopia, right eye. Strabismic amblyopia of the right eye develops when the right eye turns inward, outward, upward, or downward, causing the brain to suppress its image and rely on the other eye, resulting in poor vision development. H53.031 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering visual disturbances and blindness (h53-h54).
H53.031 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.
Document the direction of the eye turn (esotropia, exotropia, etc.) separately if documented.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for H53.031 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the direction of the eye turn (esotropia, exotropia, etc.) separately if documented
- •Early treatment with patching, glasses, or surgery can help prevent permanent vision loss