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ICD-10 Guide
ICD-10 CodesH11.129

H11.129

Billable

Conjunctival concretions, unspecified eye

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

Code Description

ICD-10 H11.129 is a billable code used to indicate a diagnosis of conjunctival concretions, unspecified eye.

Key Diagnostic Point:

Conjunctival concretions are small, white or yellowish deposits that can form within the conjunctiva, the thin membrane covering the white part of the eye and the inner surface of the eyelids. These concretions are composed of protein, lipids, and cellular debris, and they can vary in size. Clinically, patients may present with symptoms such as irritation, foreign body sensation, or mild redness, although many individuals remain asymptomatic. The anatomy involved primarily includes the conjunctiva, but adjacent structures such as the sclera and cornea may also be affected indirectly due to inflammation or secondary irritation. Disease progression is generally benign, but in some cases, larger concretions can lead to chronic irritation or even corneal abrasion if they come into contact with the corneal surface. Diagnostic considerations include a thorough ocular examination, often using a slit lamp to visualize the concretions. Differential diagnoses may include other conjunctival lesions or conditions that cause similar symptoms, necessitating careful evaluation to ensure accurate diagnosis and management.

Code Complexity Analysis

Complexity Rating: Low

Low Complexity

Complexity Factors

  • Diagnostic complexity: Low, as diagnosis is typically straightforward with visual examination.
  • Treatment complexity: Low, as treatment may involve simple removal or observation.
  • Documentation requirements: Moderate, requiring clear documentation of symptoms and examination findings.
  • Coding specificity: Moderate, as it is specific to conjunctival concretions but lacks granularity for underlying causes.

Audit Risk Factors

  • Common coding errors: Misuse of related codes or failure to specify laterality.
  • Documentation gaps: Lack of detailed examination notes or symptom descriptions.
  • Billing challenges: Potential denials if documentation does not clearly support the diagnosis.

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

Primary care

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

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Conjunctival concretions, while often benign, can impact patient quality of life due to discomfort or irritation. Understanding their prevalence and management is essential for population health, as they may lead to unnecessary healthcare visits if not properly addressed. Quality measures may include monitoring patient-reported outcomes related to eye health and the effectiveness of treatment protocols. Epidemiologically, conjunctival concretions are more common in older adults, highlighting the need for awareness among healthcare providers to ensure timely diagnosis and management.

ICD-9 vs ICD-10

Conjunctival concretions, while often benign, can impact patient quality of life due to discomfort or irritation. Understanding their prevalence and management is essential for population health, as they may lead to unnecessary healthcare visits if not properly addressed. Quality measures may include monitoring patient-reported outcomes related to eye health and the effectiveness of treatment protocols. Epidemiologically, conjunctival concretions are more common in older adults, highlighting the need for awareness among healthcare providers to ensure timely diagnosis and management.

Reimbursement & Billing Impact

Reimbursement may vary based on the payer, so it is crucial to check specific payer policies. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Coders should ensure that the medical record supports the diagnosis and any procedures performed, including detailed notes on the examination and treatment plan. Best practices include using clear and concise language in documentation and ensuring that all relevant clinical information is included.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for H00-H99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for H00-H99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by H11.129?

H11.129 specifically covers conjunctival concretions that are not further specified by laterality or additional descriptors. It does not include other conjunctival disorders such as conjunctivitis or pterygium.

When should H11.129 be used instead of related codes?

H11.129 should be used when the clinician identifies conjunctival concretions but does not specify the eye involved or when the condition is not further classified. If laterality is known, H11.121 or H11.122 should be used instead.

What documentation supports H11.129?

Documentation should include a detailed eye examination report, noting the presence of concretions, any associated symptoms, and the absence of other ocular conditions. Photographic evidence may also support the diagnosis.