H00.031
H00.031 — Abscess of right upper eyelid
Billable / specific codeICD-10-CMright
H00.031 is a billable, specific ICD-10-CM code for abscess of right upper eyelid. It is valid for submission on a claim.
Risk adjustment
H00.031 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
H00.031 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57068Billing and Coding: Ocular Photography - External
- A57637Billing and Coding: Visual Field Examination
Code history
H00.031 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share H00.03. If H00.031 is not quite right, the correct code is usually one of these.
Questions about H00.031
- Is H00.031 a billable ICD-10-CM code?
- Yes. H00.031 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H00.031 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of eyelid, lacrimal system and orbit (H00-H05).