ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesH11.4

H11.4

Non-billable

Other conjunctival vascular disorders and cysts

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

Code Description

ICD-10 H11.4 is a used to indicate a diagnosis of other conjunctival vascular disorders and cysts.

Key Diagnostic Point:

H11.4 refers to other conjunctival vascular disorders and cysts, which encompass a variety of conditions affecting the conjunctiva, a thin membrane covering the white part of the eye and the inner eyelids. Clinically, patients may present with symptoms such as redness, swelling, irritation, or the presence of cysts. The anatomy involved primarily includes the conjunctiva, but may also extend to adjacent structures like the sclera and cornea. Disease progression can vary; some conditions may be benign and self-limiting, while others could lead to complications if left untreated. Diagnostic considerations include a thorough ocular examination, patient history, and potentially imaging studies or biopsy to differentiate between various conjunctival lesions. Conditions such as conjunctival cysts, conjunctival hemangiomas, and other vascular malformations fall under this code, necessitating careful evaluation to determine the appropriate management and treatment options.

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

Dermatology

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

The clinical significance of H11.4 lies in its potential to affect visual health and quality of life for patients. These conditions can lead to discomfort, cosmetic concerns, and in some cases, complications if not properly managed. Understanding the epidemiology of conjunctival vascular disorders can aid in population health initiatives, as timely diagnosis and treatment can reduce healthcare utilization and improve patient outcomes.

ICD-9 vs ICD-10

The clinical significance of H11.4 lies in its potential to affect visual health and quality of life for patients. These conditions can lead to discomfort, cosmetic concerns, and in some cases, complications if not properly managed. Understanding the epidemiology of conjunctival vascular disorders can aid in population health initiatives, as timely diagnosis and treatment can reduce healthcare utilization and improve patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the complexity of the condition and the treatment provided. Common denials can arise from insufficient documentation or failure to provide detailed clinical notes. It is advisable to follow coding best practices, including using the most specific code available and ensuring that all services rendered are well-documented to support the medical necessity of the treatment.

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 H11.4?

H11.4 covers conditions such as conjunctival cysts, conjunctival hemangiomas, and other vascular malformations of the conjunctiva. Diagnostic criteria typically include clinical examination findings and may require imaging or biopsy for confirmation.

When should H11.4 be used instead of related codes?

H11.4 should be used when the condition involves vascular disorders or cysts that do not fit into more specific categories. If the condition is purely a cyst without vascular involvement, H11.3 may be more appropriate.

What documentation supports H11.4?

Documentation should include a detailed clinical examination report, patient history, and any imaging or biopsy results that confirm the diagnosis of a conjunctival vascular disorder or cyst.