H00-H5956 V28 risk-adjusting codes
Diseases of the eye and adnexa
ICD-10-CM Chapter 7 (H00-H59) in the FY2026 code set. 56 codes in this chapter map to a CMS-HCC V28 payment category, across 3 HCC categories.
CMS-HCC V28 categories in this chapter (3)
Open any category for its full member-code list, RAF, and hierarchy.
Risk-adjusting ICD-10-CM codes (56)
Codes in this chapter that map to a CMS-HCC V28 payment category. Open any code for its full detail.
- H34.8110Central retinal vein occlusion, right eye, with macular edema
- H34.8111Central retinal vein occlusion, right eye, with retinal neovascularization
- H34.8112Central retinal vein occlusion, right eye, stable
- H34.8120Central retinal vein occlusion, left eye, with macular edema
- H34.8121Central retinal vein occlusion, left eye, with retinal neovascularization
- H34.8122Central retinal vein occlusion, left eye, stable
- H34.8130Central retinal vein occlusion, bilateral, with macular edema
- H34.8131Central retinal vein occlusion, bilateral, with retinal neovascularization
- H34.8132Central retinal vein occlusion, bilateral, stable
- H34.8190Central retinal vein occlusion, unspecified eye, with macular edema
- H34.8191Central retinal vein occlusion, unspecified eye, with retinal neovascularization
- H34.8192Central retinal vein occlusion, unspecified eye, stable
- H34.8310Tributary (branch) retinal vein occlusion, right eye, with macular edema
- H34.8311Tributary (branch) retinal vein occlusion, right eye, with retinal neovascularization
- H34.8312Tributary (branch) retinal vein occlusion, right eye, stable
- H34.8320Tributary (branch) retinal vein occlusion, left eye, with macular edema
- H34.8321Tributary (branch) retinal vein occlusion, left eye, with retinal neovascularization
- H34.8322Tributary (branch) retinal vein occlusion, left eye, stable
- H34.8330Tributary (branch) retinal vein occlusion, bilateral, with macular edema
- H34.8331Tributary (branch) retinal vein occlusion, bilateral, with retinal neovascularization
- H34.8332Tributary (branch) retinal vein occlusion, bilateral, stable
- H34.8390Tributary (branch) retinal vein occlusion, unspecified eye, with macular edema
- H34.8391Tributary (branch) retinal vein occlusion, unspecified eye, with retinal neovascularization
- H34.8392Tributary (branch) retinal vein occlusion, unspecified eye, stable
- H35.3210Exudative age-related macular degeneration, right eye, stage unspecified
- H35.3211Exudative age-related macular degeneration, right eye, with active choroidal neovascularization
- H35.3212Exudative age-related macular degeneration, right eye, with inactive choroidal neovascularization
- H35.3213Exudative age-related macular degeneration, right eye, with inactive scar
- H35.3220Exudative age-related macular degeneration, left eye, stage unspecified
- H35.3221Exudative age-related macular degeneration, left eye, with active choroidal neovascularization
- H35.3222Exudative age-related macular degeneration, left eye, with inactive choroidal neovascularization
- H35.3223Exudative age-related macular degeneration, left eye, with inactive scar
- H35.3230Exudative age-related macular degeneration, bilateral, stage unspecified
- H35.3231Exudative age-related macular degeneration, bilateral, with active choroidal neovascularization
- H35.3232Exudative age-related macular degeneration, bilateral, with inactive choroidal neovascularization
- H35.3233Exudative age-related macular degeneration, bilateral, with inactive scar
- H35.3290Exudative age-related macular degeneration, unspecified eye, stage unspecified
- H35.3291Exudative age-related macular degeneration, unspecified eye, with active choroidal neovascularization
- H35.3292Exudative age-related macular degeneration, unspecified eye, with inactive choroidal neovascularization
- H35.3293Exudative age-related macular degeneration, unspecified eye, with inactive scar
- H36.811Nonproliferative sickle-cell retinopathy, right eye
- H36.812Nonproliferative sickle-cell retinopathy, left eye
- H36.813Nonproliferative sickle-cell retinopathy, bilateral
- H36.819Nonproliferative sickle-cell retinopathy, unspecified eye
- H36.821Proliferative sickle-cell retinopathy, right eye
- H36.821Proliferative sickle-cell retinopathy, right eye
- H36.822Proliferative sickle-cell retinopathy, left eye
- H36.822Proliferative sickle-cell retinopathy, left eye
- H36.823Proliferative sickle-cell retinopathy, bilateral
- H36.823Proliferative sickle-cell retinopathy, bilateral
- H36.829Proliferative sickle-cell retinopathy, unspecified eye
- H36.829Proliferative sickle-cell retinopathy, unspecified eye
- H43.10Vitreous hemorrhage, unspecified eye
- H43.11Vitreous hemorrhage, right eye
- H43.12Vitreous hemorrhage, left eye
- H43.13Vitreous hemorrhage, bilateral
Frequently asked questions
How many ICD-10-CM codes in Diseases of the eye and adnexa risk-adjust under CMS-HCC V28?
56 ICD-10-CM codes in the H00-H59 chapter (Diseases of the eye and adnexa) map to a CMS-HCC V28 payment category for payment year 2026.
Which CMS-HCC V28 categories do H00-H59 codes map to?
Codes in this chapter map to 3 distinct CMS-HCC V28 categories, most commonly HCC 298 (Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage), HCC 300 (Exudative Macular Degeneration), HCC 108 (Sickle Cell Disorders, Except Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major).
What ICD-10-CM chapter is H00-H59?
H00-H59 is ICD-10-CM Chapter 7, Diseases of the eye and adnexa, in the FY2026 code set.
Source: FY2026 ICD-10-CM Tabular (CDC/NCHS) and the CMS-HCC v28 PY2026 mapping file.