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ICD-10 Guide
ICD-10 CodesH11.041

H11.041

Billable

Peripheral pterygium, stationary, right eye

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 H11.041 is a billable code used to indicate a diagnosis of peripheral pterygium, stationary, right eye.

Key Diagnostic Point:

Peripheral pterygium, stationary, right eye

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity
Peripheral pterygium is generally considered a benign condition; however, management may vary based on symptoms and progression. Surgical intervention may be required for symptomatic cases or significant encroachment on the visual axis.

Specialty Focus

Medical Specialties

Ophthalmology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Optometry

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Coding Guidelines

Inclusion Criteria

Use H11.041 When
  • Ensure accurate documentation of the diagnosis and any associated symptoms
  • Note the laterality (right eye) and specify if the pterygium is stationary
  • Include any relevant examination findings and treatment plans

Exclusion Criteria

Do NOT use H11.041 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Accurate coding of H11.041 is crucial for proper reimbursement and tracking of eye conditions. Misclassification may lead to claim denials or delays in payment. It also aids in the collection of data for epidemiological studies.

ICD-9 vs ICD-10

Accurate coding of H11.041 is crucial for proper reimbursement and tracking of eye conditions. Misclassification may lead to claim denials or delays in payment. It also aids in the collection of data for epidemiological studies.

Reimbursement & Billing Impact

reimbursement and tracking of eye conditions. Misclassification may lead to claim denials or delays in payment. It also aids in the collection of data for epidemiological studies.

Resources

Clinical References

  • •
    American Academy of Ophthalmology - Pterygium
  • •
    MedlinePlus - Pterygium
  • •
    American Optometric Association - Pterygium Management

Coding & Billing References

  • •
    American Academy of Ophthalmology - Pterygium
  • •
    MedlinePlus - Pterygium
  • •
    American Optometric Association - Pterygium Management

Frequently Asked Questions

What is a peripheral pterygium?

A peripheral pterygium is a benign growth of tissue on the conjunctiva that can extend onto the cornea. It is often associated with UV exposure and can cause irritation or visual disturbances.

How is a stationary pterygium managed?

A stationary pterygium may be monitored if asymptomatic. If it causes discomfort or affects vision, treatment options include lubricating eye drops or surgical excision.

What are the risks of pterygium surgery?

Risks include recurrence of the pterygium, infection, and complications related to anesthesia. Proper patient selection and surgical technique can minimize these risks.