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Z46.0

Billable

Encounter for fitting and adjustment of spectacles and contact lenses

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

Is Z46.0 an HCC code?

No. Z46.0 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

Z46.0 is the ICD-10-CM diagnosis code for encounter for fitting and adjustment of spectacles and contact lenses. A patient visit to get fitted for or have adjustments made to eyeglasses or contact lenses. Z46.0 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering encounters for other specific health care (z40-z53).

Z46.0 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.

This code is used for routine eye care visits focused on vision correction devices, not for eye exams or treatment of eye diseases.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z46.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • This code is used for routine eye care visits focused on vision correction devices, not for eye exams or treatment of eye diseases
  • Document whether the visit is for initial fitting, adjustment, or replacement of spectacles or contact lenses

Code Hierarchy

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