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ICD-10 Guide
ICD-10 CodesH11.229

H11.229

Billable

Conjunctival granuloma, unspecified

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

Code Description

ICD-10 H11.229 is a billable code used to indicate a diagnosis of conjunctival granuloma, unspecified.

Key Diagnostic Point:

Conjunctival granuloma, unspecified, is characterized by a localized inflammatory response in the conjunctiva, often presenting as a raised, red, or pink lesion. This condition may arise due to various etiologies, including foreign body reactions, infections, or chronic inflammation. The conjunctiva is a thin, transparent membrane covering the white part of the eyeball and the inner surface of the eyelids, playing a crucial role in protecting the eye and maintaining moisture. Disease progression can vary; while some granulomas may resolve spontaneously, others may persist or enlarge, potentially leading to discomfort, irritation, or visual disturbances. Diagnostic considerations include a thorough ocular examination, patient history, and possibly imaging or biopsy to rule out malignancy or other underlying conditions. It is essential to differentiate conjunctival granulomas from other conjunctival lesions, such as papillomas or cysts, to ensure appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differential diagnosis to rule out other conjunctival lesions.
  • Treatment complexity: May involve observation, corticosteroid injections, or surgical excision depending on size and symptoms.
  • Documentation requirements: Detailed clinical notes and history are necessary for accurate coding.
  • Coding specificity: While H11.229 is specific, related codes may require more detail regarding the underlying cause.

Audit Risk Factors

  • Common coding errors: Misclassification of granulomas as other conjunctival disorders.
  • Documentation gaps: Incomplete patient history or lack of detailed examination notes.
  • Billing challenges: Potential denials if the rationale for the diagnosis is not clearly 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

Allergy and Immunology

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 often benign, can significantly impact patient quality of life due to discomfort and potential visual disturbances. Understanding the epidemiology of this condition is crucial, as it may be associated with allergic reactions or environmental factors. Monitoring and managing conjunctival granulomas can lead to improved patient outcomes and reduced healthcare utilization, particularly in populations with higher incidences of allergic conjunctivitis or foreign body exposure.

ICD-9 vs ICD-10

Conjunctival granulomas, while often benign, can significantly impact patient quality of life due to discomfort and potential visual disturbances. Understanding the epidemiology of this condition is crucial, as it may be associated with allergic reactions or environmental factors. Monitoring and managing conjunctival granulomas can lead to improved patient outcomes and reduced healthcare utilization, particularly in populations with higher incidences of allergic conjunctivitis or foreign body exposure.

Reimbursement & Billing Impact

Reimbursement may be affected by the specificity of the diagnosis; therefore, coders should ensure that all relevant clinical details are included in the medical record. Common denials may arise from insufficient documentation or failure to provide a clear link between the diagnosis and the services rendered. Best practices include thorough documentation of the examination findings, treatment plans, and any patient education provided.

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 H11.229?

H11.229 covers unspecified conjunctival granulomas, which may arise from various causes including foreign bodies, infections, or chronic inflammatory conditions. It does not specify the underlying etiology, making it essential to document the clinical findings accurately.

When should H11.229 be used instead of related codes?

H11.229 should be used when a conjunctival granuloma is diagnosed but the specific cause is not identified. If the etiology is known, a more specific code should be selected to reflect the underlying condition.

What documentation supports H11.229?

Documentation should include a comprehensive eye examination, patient history detailing symptoms and duration, any previous treatments, and the results of any diagnostic tests performed to support the diagnosis of conjunctival granuloma.