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ICD-10 Guide
ICD-10 CodesH11.22

H11.22

Non-billable

Conjunctival granuloma

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

Code Description

ICD-10 H11.22 is a used to indicate a diagnosis of conjunctival granuloma.

Key Diagnostic Point:

Conjunctival granuloma is a benign, localized inflammatory lesion that arises from the conjunctiva, often due to chronic irritation, foreign body reaction, or infection. Clinically, it presents as a raised, red, or pink mass on the conjunctiva, which may be asymptomatic or cause discomfort, tearing, or visual disturbances depending on its size and location. The conjunctiva is the mucous membrane covering the white part of the eyeball and the inner eyelids, playing a crucial role in eye health. Disease progression can vary; while some granulomas may resolve spontaneously, others may persist or enlarge, necessitating intervention. Diagnostic considerations include a thorough ocular examination, patient history, and possibly imaging or biopsy to rule out malignancy or other conditions. It is essential to differentiate conjunctival granulomas from other conjunctival lesions such as papillomas, cysts, or neoplasms to ensure appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

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 granulomas, while generally benign, can affect patient quality of life and visual function if left untreated. Understanding the epidemiology of conjunctival lesions helps in recognizing patterns of healthcare utilization, particularly in populations with higher incidences of chronic eye conditions. Quality measures may include timely diagnosis and appropriate management, which can lead to improved patient outcomes and reduced healthcare costs.

ICD-9 vs ICD-10

Conjunctival granulomas, while generally benign, can affect patient quality of life and visual function if left untreated. Understanding the epidemiology of conjunctival lesions helps in recognizing patterns of healthcare utilization, particularly in populations with higher incidences of chronic eye conditions. Quality measures may include timely diagnosis and appropriate management, which can lead to improved patient outcomes and reduced healthcare costs.

Reimbursement & Billing Impact

reimbursement success.

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 H11.22?

H11.22 specifically covers conjunctival granulomas, which can arise from various causes including chronic inflammation, foreign body reactions, or infections. It does not include other conjunctival lesions such as cysts or tumors.

When should H11.22 be used instead of related codes?

H11.22 should be used when a diagnosis of conjunctival granuloma is confirmed, particularly when the lesion is symptomatic or requires treatment. It should not be used for other conjunctival conditions that do not meet the criteria for granuloma.

What documentation supports H11.22?

Documentation should include a detailed patient history, clinical examination findings, and any diagnostic tests performed. Photographic evidence of the lesion and notes on treatment decisions are also beneficial.