H15.811
H15.811 — Equatorial staphyloma, right eye
Billable / specific codeICD-10-CMright
H15.811 is a billable, specific ICD-10-CM code for equatorial staphyloma, right eye. It is valid for submission on a claim.
Risk adjustment
H15.811 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
H15.811 is named in 3 Medicare coverage policies — 3 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
- A57068Billing and Coding: Ocular Photography - External
- A57483Billing and Coding: Visual Fields
Related codes at this level
Codes that share H15.81. If H15.811 is not quite right, the correct code is usually one of these.
Questions about H15.811
- Is H15.811 a billable ICD-10-CM code?
- Yes. H15.811 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H15.811 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of sclera, cornea, iris and ciliary body (H15-H22).