Question 1

What is ICD-10 code H57.8A9?

Accepted Answer

H57.8A9 is the ICD-10-CM diagnosis code for foreign body sensation, unspecified eye. A sensation of having something in the eye when the specific eye is not documented or affects both eyes. H57.8A9 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering other disorders of eye and adnexa (h55-h57).

H57.8A9 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 documentation.

Question 2

Is H57.8A9 an HCC code?

Accepted Answer

No. H57.8A9 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is H57.8A9 billable?

Accepted Answer

Yes. H57.8A9 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. H57.8A9 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

What is the V28 vs V24 difference for H57.8A9?

Accepted Answer

H57.8A9 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards H57.8A9 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

Question 5

What should coders know when reporting H57.8A9?

Accepted Answer

Use this code only when laterality cannot be determined from documentation Query provider if documentation indicates a specific eye to allow for more precise coding

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H57.8A9

Is H57.8A9 an HCC code?

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Open H57.8A9 in the Interactive Encoder

H57.8A9 ICD-10-CM Code: Foreign body sensation, unspecified eye

HCC Buddy Code Card

H57.8A9

Is H57.8A9 an HCC code?

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Open H57.8A9 in the Interactive Encoder