ICD-10-CM Billable Code

H11.001

Unspecified pterygium of right eye

Clinical Classification Guidelines

Medical Intelligence & Overview

Pterygium is a common eye condition characterized by a benign growth of fleshy tissue on the conjunctiva, the clear tissue covering the white part of the eye. When this growth extends onto the cornea, it can affect vision and eye comfort. ICD-10 Code H11.001 refers specifically to an unspecified pterygium affecting the right eye, meaning the precise type or extent of the condition has not been detailed. This condition generally develops gradually and can be associated with various environmental and health factors.

Causes & Symptoms

Clinical Causes: Chronic exposure to ultraviolet (UV) light from sunlight Exposure to wind, dust, and environmental irritants Dry eye conditions Living in arid or dusty climates Genetic predisposition or family history Prolonged eye strain or irritation

Key Symptoms: A visible flesh-colored growth on the conjunctiva Redness and inflammation around the growth A feeling of grittiness or irritation in the eye Dryness or burning sensation Blurred or decreased vision if the growth extends onto the cornea A sensation of eye fullness or foreign body sensation

Diagnostic & Treatment

Diagnosis Path: Diagnosis of pterygium involves a comprehensive eye examination by an eye care professional. The examination typically includes visual acuity tests and slit-lamp microscopy to visualize the growth's size and extent. The specialist assesses whether the growth encroaches upon the cornea and affects vision. Additional imaging tests are rarely necessary but can be employed if the diagnosis is uncertain or to evaluate the extent of infiltration.

Treatment Protocols: Treatment options depend on the severity and impact of the pterygium. They can include:

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.

Clinical Advice & FAQs

Billing Guidance

Is H11.001 a billable ICD-10 code?
Yes, H11.001 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report H11.001?
Clinical documentation must specify the nature of Unspecified pterygium of right eye and any associated comorbidities for accurate reporting.

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