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298 HCC

Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage

CMS Model V28 180 Associated ICD-10 Diagnoses

Relative Risk Score Factors (Coefficients for HCC 298)

Enrollment Model Type Coeff Tag Year Weight Score
CFA HCC298 2026 + 0.323
CFD HCC298 2026 + 0.319
CNA HCC298 2026 + 0.336
CND HCC298 2026 + 0.364
CPA HCC298 2026 + 0.327
CPD HCC298 2026 + 0.301
INS HCC298 2026 + 0.545

Mapped ICD-10-CM Diagnoses (180)

The following diagnoses map directly to HCC 298 under the V28 risk adjustment model:

ICD-10 Code Clinical Diagnosis Description Guideline
E08.311 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema Notes ↗
E08.3211 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, right eye Notes ↗
E08.3212 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, left eye Notes ↗
E08.3213 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, bilateral Notes ↗
E08.3219 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye Notes ↗
E08.3311 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, right eye Notes ↗
E08.3312 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, left eye Notes ↗
E08.3313 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, bilateral Notes ↗
E08.3319 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye Notes ↗
E08.3411 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, right eye Notes ↗
E08.3412 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, left eye Notes ↗
E08.3413 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, bilateral Notes ↗
E08.3419 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye Notes ↗
E08.3511 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, right eye Notes ↗
E08.3512 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, left eye Notes ↗
E08.3513 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, bilateral Notes ↗
E08.3519 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, unspecified eye Notes ↗
E08.3521 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye Notes ↗
E08.3522 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye Notes ↗
E08.3523 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral Notes ↗
E08.3529 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye Notes ↗
E08.3531 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye Notes ↗
E08.3532 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye Notes ↗
E08.3533 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral Notes ↗
E08.3539 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye Notes ↗
E08.3541 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye Notes ↗
E08.3542 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye Notes ↗
E08.3543 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral Notes ↗
E08.3549 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye Notes ↗
E08.3551 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, right eye Notes ↗
E08.3552 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, left eye Notes ↗
E08.3553 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, bilateral Notes ↗
E08.3559 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, unspecified eye Notes ↗
E08.3591 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, right eye Notes ↗
E08.3592 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, left eye Notes ↗
E08.3593 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, bilateral Notes ↗
E08.3599 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, unspecified eye Notes ↗
E10.311 Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema Notes ↗
E10.3211 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye Notes ↗
E10.3212 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye Notes ↗
E10.3213 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral Notes ↗
E10.3219 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye Notes ↗
E10.3311 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye Notes ↗
E10.3312 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye Notes ↗
E10.3313 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral Notes ↗
E10.3319 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye Notes ↗
E10.3411 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye Notes ↗
E10.3412 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye Notes ↗
E10.3413 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral Notes ↗
E10.3419 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye Notes ↗
E10.3511 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye Notes ↗
E10.3512 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye Notes ↗
E10.3513 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral Notes ↗
E10.3519 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye Notes ↗
E10.3521 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye Notes ↗
E10.3522 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye Notes ↗
E10.3523 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral Notes ↗
E10.3529 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye Notes ↗
E10.3531 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye Notes ↗
E10.3532 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye Notes ↗
E10.3533 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral Notes ↗
E10.3539 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye Notes ↗
E10.3541 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye Notes ↗
E10.3542 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye Notes ↗
E10.3543 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral Notes ↗
E10.3549 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye Notes ↗
E10.3551 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, right eye Notes ↗
E10.3552 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, left eye Notes ↗
E10.3553 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral Notes ↗
E10.3559 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye Notes ↗
E10.3591 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye Notes ↗
E10.3592 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye Notes ↗
E10.3593 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral Notes ↗
E10.3599 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye Notes ↗
E11.311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema Notes ↗
E11.3211 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye Notes ↗
E11.3212 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye Notes ↗
E11.3213 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral Notes ↗
E11.3219 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye Notes ↗
E11.3311 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye Notes ↗
E11.3312 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye Notes ↗
E11.3313 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral Notes ↗
E11.3319 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye Notes ↗
E11.3411 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye Notes ↗
E11.3412 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye Notes ↗
E11.3413 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral Notes ↗
E11.3419 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye Notes ↗
E11.3511 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye Notes ↗
E11.3512 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye Notes ↗
E11.3513 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral Notes ↗
E11.3519 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye Notes ↗
E11.3521 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye Notes ↗
E11.3522 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye Notes ↗
E11.3523 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral Notes ↗
E11.3529 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye Notes ↗
E11.3531 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye Notes ↗
E11.3532 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye Notes ↗
E11.3533 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral Notes ↗
E11.3539 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye Notes ↗
E11.3541 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye Notes ↗
E11.3542 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye Notes ↗
E11.3543 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral Notes ↗
E11.3549 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye Notes ↗
E11.3551 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, right eye Notes ↗
E11.3552 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left eye Notes ↗
E11.3553 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral Notes ↗
E11.3559 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye Notes ↗
E11.3591 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye Notes ↗
E11.3592 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye Notes ↗
E11.3593 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral Notes ↗
E11.3599 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye Notes ↗
E13.311 Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema Notes ↗
E13.3211 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye Notes ↗
E13.3212 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye Notes ↗
E13.3213 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral Notes ↗
E13.3219 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye Notes ↗
E13.3311 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye Notes ↗
E13.3312 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye Notes ↗
E13.3313 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral Notes ↗
E13.3319 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye Notes ↗
E13.3411 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye Notes ↗
E13.3412 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye Notes ↗
E13.3413 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral Notes ↗
E13.3419 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye Notes ↗
E13.3511 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye Notes ↗
E13.3512 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye Notes ↗
E13.3513 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral Notes ↗
E13.3519 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye Notes ↗
E13.3521 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye Notes ↗
E13.3522 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye Notes ↗
E13.3523 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral Notes ↗
E13.3529 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye Notes ↗
E13.3531 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye Notes ↗
E13.3532 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye Notes ↗
E13.3533 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral Notes ↗
E13.3539 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye Notes ↗
E13.3541 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye Notes ↗
E13.3542 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye Notes ↗
E13.3543 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral Notes ↗
E13.3549 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye Notes ↗
E13.3551 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, right eye Notes ↗
E13.3552 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, left eye Notes ↗
E13.3553 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, bilateral Notes ↗
E13.3559 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye Notes ↗
E13.3591 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye Notes ↗
E13.3592 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye Notes ↗
E13.3593 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral Notes ↗
E13.3599 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye Notes ↗
H34.8110 Central retinal vein occlusion, right eye, with macular edema Notes ↗
H34.8111 Central retinal vein occlusion, right eye, with retinal neovascularization Notes ↗
H34.8112 Central retinal vein occlusion, right eye, stable Notes ↗
H34.8120 Central retinal vein occlusion, left eye, with macular edema Notes ↗
H34.8121 Central retinal vein occlusion, left eye, with retinal neovascularization Notes ↗
H34.8122 Central retinal vein occlusion, left eye, stable Notes ↗
H34.8130 Central retinal vein occlusion, bilateral, with macular edema Notes ↗
H34.8131 Central retinal vein occlusion, bilateral, with retinal neovascularization Notes ↗
H34.8132 Central retinal vein occlusion, bilateral, stable Notes ↗
H34.8190 Central retinal vein occlusion, unspecified eye, with macular edema Notes ↗
H34.8191 Central retinal vein occlusion, unspecified eye, with retinal neovascularization Notes ↗
H34.8192 Central retinal vein occlusion, unspecified eye, stable Notes ↗
H34.8310 Tributary (branch) retinal vein occlusion, right eye, with macular edema Notes ↗
H34.8311 Tributary (branch) retinal vein occlusion, right eye, with retinal neovascularization Notes ↗
H34.8312 Tributary (branch) retinal vein occlusion, right eye, stable Notes ↗
H34.8320 Tributary (branch) retinal vein occlusion, left eye, with macular edema Notes ↗
H34.8321 Tributary (branch) retinal vein occlusion, left eye, with retinal neovascularization Notes ↗
H34.8322 Tributary (branch) retinal vein occlusion, left eye, stable Notes ↗
H34.8330 Tributary (branch) retinal vein occlusion, bilateral, with macular edema Notes ↗
H34.8331 Tributary (branch) retinal vein occlusion, bilateral, with retinal neovascularization Notes ↗
H34.8332 Tributary (branch) retinal vein occlusion, bilateral, stable Notes ↗
H34.8390 Tributary (branch) retinal vein occlusion, unspecified eye, with macular edema Notes ↗
H34.8391 Tributary (branch) retinal vein occlusion, unspecified eye, with retinal neovascularization Notes ↗
H34.8392 Tributary (branch) retinal vein occlusion, unspecified eye, stable Notes ↗
H36.821 Proliferative sickle-cell retinopathy, right eye Notes ↗
H36.822 Proliferative sickle-cell retinopathy, left eye Notes ↗
H36.823 Proliferative sickle-cell retinopathy, bilateral Notes ↗
H36.829 Proliferative sickle-cell retinopathy, unspecified eye Notes ↗
H43.10 Vitreous hemorrhage, unspecified eye Notes ↗
H43.11 Vitreous hemorrhage, right eye Notes ↗
H43.12 Vitreous hemorrhage, left eye Notes ↗
H43.13 Vitreous hemorrhage, bilateral Notes ↗
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