H16.261
H16.261 — Vernal keratoconjunctivitis, with limbar and corneal involvement, right eye
Billable / specific codeICD-10-CMright
H16.261 is a billable, specific ICD-10-CM code for vernal keratoconjunctivitis, with limbar and corneal involvement, right eye. It is valid for submission on a claim.
Risk adjustment
H16.261 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
H16.261 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.
- A56559Billing and Coding: Allergy Skin Testing
- A57068Billing and Coding: Ocular Photography - External
- A57473Billing and Coding: Allergy Testing
- A57473Billing and Coding: Allergy Testing
Related codes at this level
Codes that share H16.26. If H16.261 is not quite right, the correct code is usually one of these.
Questions about H16.261
- Is H16.261 a billable ICD-10-CM code?
- Yes. H16.261 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H16.261 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).