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ICD-10 Guide
ICD-10 CodesH11.113

H11.113

Billable

Conjunctival deposits, bilateral

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

Code Description

ICD-10 H11.113 is a billable code used to indicate a diagnosis of conjunctival deposits, bilateral.

Key Diagnostic Point:

H11.113 refers to bilateral conjunctival deposits, which are abnormal accumulations of material on the conjunctiva, the thin membrane covering the white part of the eye and the inner eyelids. Clinically, these deposits can manifest as yellowish or white spots and may be associated with various underlying conditions such as conjunctival cysts, pingueculae, or even systemic diseases like hyperlipidemia. The anatomy involved primarily includes the conjunctiva, but may also relate to the sclera and cornea if deposits extend or cause irritation. Disease progression can vary; while some deposits may remain stable, others can lead to discomfort, inflammation, or visual disturbances. Diagnostic considerations include a thorough ocular examination, possibly supplemented by imaging techniques or laboratory tests to identify systemic causes. It is crucial to differentiate these deposits from other conjunctival lesions to ensure appropriate management and treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

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

Audit Risk Factors

  • Common coding errors include misidentifying unilateral versus bilateral deposits.
  • Documentation gaps may arise if the underlying cause of deposits is not clearly stated.
  • Billing challenges can occur if the relationship between deposits and systemic conditions is not well documented.

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

The clinical significance of H11.113 lies in its potential association with systemic health issues, such as hyperlipidemia, which can have broader implications for patient health. Understanding and identifying conjunctival deposits can lead to early intervention and management of underlying conditions, ultimately improving population health outcomes. Quality measures may include tracking the incidence of conjunctival deposits and their correlation with systemic diseases, influencing healthcare utilization patterns and resource allocation.

ICD-9 vs ICD-10

The clinical significance of H11.113 lies in its potential association with systemic health issues, such as hyperlipidemia, which can have broader implications for patient health. Understanding and identifying conjunctival deposits can lead to early intervention and management of underlying conditions, ultimately improving population health outcomes. Quality measures may include tracking the incidence of conjunctival deposits and their correlation with systemic diseases, influencing healthcare utilization patterns and resource allocation.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the medical necessity for the examination and any treatments is clearly documented. Common denials may arise from insufficient documentation linking the deposits to a specific diagnosis or from coding errors related to unilateral versus bilateral conditions. Best practices include maintaining thorough clinical notes and ensuring that all relevant tests and evaluations are documented.

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 H11.113?

H11.113 encompasses bilateral conjunctival deposits which may arise from conditions such as pingueculae, conjunctival cysts, or systemic issues like hyperlipidemia. Each condition has specific diagnostic criteria that must be met for accurate coding.

When should H11.113 be used instead of related codes?

H11.113 should be used when bilateral conjunctival deposits are present and documented. It is crucial to differentiate from unilateral codes or other conjunctival disorders based on clinical findings and examination results.

What documentation supports H11.113?

Documentation for H11.113 should include a detailed ocular examination report, descriptions of the deposits, any associated symptoms, and results from any relevant tests that may indicate underlying systemic conditions.