H54.2X21 ICD-10-CM Code: Low vision right eye category 2, low vision left eye category 1
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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Visual disturbances and blindness (H53-H54)
H54.2X21
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceLow vision right eye category 2, low vision left eye category 1
Moderate low vision in the right eye and mild low vision in the left eye. Vision is reduced in both eyes with the right eye more affected.
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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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for H54.2X21 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for H54.2X21 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H54.2X21 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H54.2X21 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H54.2X21 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H54.2X21 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H54.2X21 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 H54.2X21 an HCC code?
No. H54.2X21 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
H54.2X21 is the ICD-10-CM diagnosis code for low vision right eye category 2, low vision left eye category 1. Moderate low vision in the right eye and mild low vision in the left eye. Vision is reduced in both eyes with the right eye more affected. H54.2X21 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).
H54.2X21 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.
Right eye is category 2 (moderate low vision) and left eye is category 1 (mild low vision); document acuity measurements for each eye separately.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H54.2X21 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Right eye is category 2 (moderate low vision) and left eye is category 1 (mild low vision); document acuity measurements for each eye separately.
- •Note whether the patient has a preferred eye for reading or detailed tasks.