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 CodesH11.011

H11.011

Billable

Amyloid pterygium of right eye

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

Code Description

ICD-10 H11.011 is a billable code used to indicate a diagnosis of amyloid pterygium of right eye.

Key Diagnostic Point:

Amyloid pterygium of the right eye is a rare ocular condition characterized by the deposition of amyloid protein in the conjunctiva, leading to a yellowish-white, gelatinous appearance. This condition typically presents as a growth on the conjunctiva, which may extend onto the cornea, potentially affecting vision. The anatomy involved includes the conjunctiva, which is the membrane covering the white part of the eye and the inner eyelids, as well as the cornea, which is the transparent front part of the eye. Disease progression can vary; while some patients may experience minimal symptoms, others may develop significant visual impairment due to corneal involvement. Diagnostic considerations include a thorough ocular examination, often supplemented by biopsy to confirm the presence of amyloid deposits. Differential diagnoses may include other conjunctival lesions such as pterygium, conjunctival cysts, or neoplasms. Early detection and management are crucial to prevent complications and preserve vision.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires histological confirmation of amyloid deposits.
  • Treatment complexity: Management may involve surgical excision or monitoring.
  • Documentation requirements: Detailed clinical notes and biopsy results are essential.
  • Coding specificity: Specific to amyloid pterygium of the right eye.

Audit Risk Factors

  • Common coding errors: Misidentification of the condition as a simple pterygium.
  • Documentation gaps: Lack of biopsy results or detailed clinical findings.
  • Billing challenges: Potential denials due to insufficient documentation.

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

Pathology

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

Amyloid pterygium, while rare, can significantly impact visual health if not diagnosed and managed appropriately. Understanding its prevalence in specific populations can aid in early detection and treatment, ultimately improving patient outcomes. Quality measures may include monitoring for visual acuity changes and ensuring timely referrals to specialists. Epidemiological studies can help identify risk factors associated with amyloid deposition in the eye.

ICD-9 vs ICD-10

Amyloid pterygium, while rare, can significantly impact visual health if not diagnosed and managed appropriately. Understanding its prevalence in specific populations can aid in early detection and treatment, ultimately improving patient outcomes. Quality measures may include monitoring for visual acuity changes and ensuring timely referrals to specialists. Epidemiological studies can help identify risk factors associated with amyloid deposition in the eye.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of surgical intervention if indicated, as well as the potential for follow-up visits. Common denials may arise from insufficient documentation, particularly if biopsy results are not included. Best practices include ensuring that all clinical findings are well-documented and that the medical necessity for any procedures is clearly articulated in the patient's record.

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 H11.011?

H11.011 specifically covers amyloid pterygium of the right eye, characterized by amyloid deposits in the conjunctiva. It is distinct from other conjunctival growths and requires histological confirmation.

When should H11.011 be used instead of related codes?

H11.011 should be used when the diagnosis is confirmed as amyloid pterygium of the right eye, differentiating it from other conditions such as pterygium or conjunctival cysts, which have different codes.

What documentation supports H11.011?

Documentation should include a comprehensive ocular examination, clinical findings, and biopsy results confirming amyloid deposits. Detailed notes on the patient's symptoms and treatment plan are also necessary.