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ICD-10 Guide
ICD-10 CodesH11.44

H11.44

Non-billable

Conjunctival cysts

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

Code Description

ICD-10 H11.44 is a used to indicate a diagnosis of conjunctival cysts.

Key Diagnostic Point:

Conjunctival cysts, also known as conjunctival retention cysts, are benign lesions that occur on the conjunctiva, the clear membrane covering the white part of the eye and the inner eyelids. Clinically, these cysts present as smooth, translucent, dome-shaped swellings that can vary in size. They are typically asymptomatic but may cause discomfort or irritation if they become large enough to interfere with eyelid movement or vision. The conjunctiva is a vital part of the eye's anterior segment, providing protection and lubrication. Conjunctival cysts can arise from various causes, including obstruction of the conjunctival glands, trauma, or inflammation. Disease progression is generally slow, and these cysts rarely lead to serious complications. Diagnosis is primarily clinical, often confirmed through a slit-lamp examination. Differential diagnoses include other conjunctival lesions such as papillomas, dermoids, or conjunctival tumors, necessitating careful evaluation. In some cases, imaging may be warranted to rule out other conditions. Treatment is usually not required unless the cysts cause significant symptoms, in which case surgical excision may be performed.

Code Complexity Analysis

Complexity Rating: Low

Low Complexity

Complexity Factors

  • Diagnostic complexity: Low - primarily clinical diagnosis
  • Treatment complexity: Low - often self-limiting or minor surgical intervention
  • Documentation requirements: Moderate - requires clear clinical notes
  • Coding specificity: Low - straightforward coding with minimal variations

Audit Risk Factors

  • Common coding errors: Misclassification with other conjunctival lesions
  • Documentation gaps: Incomplete clinical notes regarding cyst characteristics
  • Billing challenges: Potential denials if documentation does not support the diagnosis

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

Conjunctival cysts, while generally benign, can impact patient quality of life if they cause discomfort or visual disturbances. Understanding their prevalence and management is crucial for optimizing patient care. Population health considerations include the need for awareness of these lesions among healthcare providers to ensure timely diagnosis and treatment. Effective management can reduce healthcare utilization patterns associated with unnecessary procedures or complications.

ICD-9 vs ICD-10

Conjunctival cysts, while generally benign, can impact patient quality of life if they cause discomfort or visual disturbances. Understanding their prevalence and management is crucial for optimizing patient care. Population health considerations include the need for awareness of these lesions among healthcare providers to ensure timely diagnosis and treatment. Effective management can reduce healthcare utilization patterns associated with unnecessary procedures or complications.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of the procedure if surgical intervention is performed. Common denials may arise if the documentation does not adequately describe the cyst's characteristics or if the procedure is deemed unnecessary. Coders should ensure that the procedure codes align with the diagnosis and that all relevant clinical notes are included to support the claim.

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 H11.44?

H11.44 specifically covers conjunctival cysts, which are benign lesions on the conjunctiva. It does not include other conjunctival disorders such as conjunctivitis or conjunctival tumors.

When should H11.44 be used instead of related codes?

H11.44 should be used when a patient presents with a conjunctival cyst that is asymptomatic or symptomatic but does not require extensive intervention. If the lesion is a papilloma or other type of growth, the appropriate related code should be selected.

What documentation supports H11.44?

Documentation should include a detailed description of the cyst's appearance, location, size, and any associated symptoms. Clinical notes should also reflect the examination findings and any treatment provided.