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ICD-10 Guide
ICD-10 CodesH11.111

H11.111

Billable

Conjunctival deposits, right eye

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

Code Description

ICD-10 H11.111 is a billable code used to indicate a diagnosis of conjunctival deposits, right eye.

Key Diagnostic Point:

H11.111 refers to conjunctival deposits in the right eye, which can manifest as yellowish or white spots on the conjunctiva due to various underlying conditions. These deposits may be associated with systemic diseases, such as hyperlipidemia, or local irritations and inflammation. The conjunctiva is a thin membrane covering the white part of the eyeball and the inner eyelids, playing a crucial role in eye health. The presence of deposits can indicate chronic irritation or systemic metabolic disorders. Disease progression may vary; some deposits may remain stable, while others can lead to complications such as inflammation or discomfort. Diagnostic considerations include a thorough ocular examination, patient history, and possibly laboratory tests to identify underlying systemic conditions. It is essential to differentiate conjunctival deposits from other ocular conditions, such as pterygium or pinguecula, which may require different management approaches.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other ocular conditions.
  • Treatment complexity: May involve addressing underlying systemic issues.
  • Documentation requirements: Detailed clinical notes needed to support diagnosis.
  • Coding specificity: Specific to right eye deposits, necessitating accurate coding.

Audit Risk Factors

  • Common coding errors: Misidentification of laterality or condition.
  • Documentation gaps: Incomplete patient history or examination notes.
  • Billing challenges: Potential denials if not properly substantiated.

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

Internal Medicine

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of H11.111 lies in its potential association with systemic conditions, which can impact overall patient health. Understanding the prevalence of conjunctival deposits can inform population health strategies and improve screening for underlying diseases. Quality measures may include monitoring the incidence of conjunctival deposits and ensuring appropriate follow-up care. Epidemiologically, awareness of conjunctival deposits can lead to better healthcare utilization patterns, as early detection and management can prevent complications.

ICD-9 vs ICD-10

The clinical significance of H11.111 lies in its potential association with systemic conditions, which can impact overall patient health. Understanding the prevalence of conjunctival deposits can inform population health strategies and improve screening for underlying diseases. Quality measures may include monitoring the incidence of conjunctival deposits and ensuring appropriate follow-up care. Epidemiologically, awareness of conjunctival deposits can lead to better healthcare utilization patterns, as early detection and management can prevent complications.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the payer, but accurate coding and thorough documentation are essential to minimize denials. Common billing challenges include discrepancies in laterality and insufficient clinical evidence to support the diagnosis. Adhering to coding best practices, such as using modifiers when necessary, can enhance the billing process.

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 H11.111?

H11.111 covers conjunctival deposits that may arise from conditions such as conjunctival cysts, lipid deposits due to systemic hyperlipidemia, or chronic irritation from environmental factors. Diagnostic criteria typically involve clinical examination and may include imaging or laboratory tests to rule out systemic causes.

When should H11.111 be used instead of related codes?

H11.111 should be used specifically when deposits are present in the right eye. If deposits are bilateral or located in the left eye, H11.112 should be used. Accurate documentation of the clinical findings and laterality is crucial for appropriate code selection.

What documentation supports H11.111?

Documentation should include a detailed ocular examination noting the characteristics of the deposits, patient history regarding systemic conditions, and any relevant laboratory findings. Clear notation of the right eye involvement is essential for coding accuracy.