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H02.411

H02.411Mechanical ptosis of right eyelid

Billable / specific codeICD-10-CMright

H02.411 is a billable, specific ICD-10-CM code for mechanical ptosis of right eyelid. It is valid for submission on a claim.

Risk adjustment

H02.411 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

H02.411 is named in 10 Medicare coverage policies 10 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

  • A56439Billing and Coding: Blepharoplasty
  • A56503Billing and Coding: Blepharoplasty, Eyelid Surgery, and Brow Lift
  • A56551Billing and Coding: Visual Fields Testing
  • A56799Billing and Coding: Visual Fields Testing

Related codes at this level

Codes that share H02.41. If H02.411 is not quite right, the correct code is usually one of these.

Questions about H02.411

Is H02.411 a billable ICD-10-CM code?
Yes. H02.411 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does H02.411 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).
ICD-10-CMFY2026-Apr· effective April 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release — see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.