ICD-10-CM Code For Other Disorders Of Conjunctiva: Group Overview

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group H11 includes non-infectious and non-traumatic disorders of the conjunctiva, such as conjunctival cysts, concretions, pannus, and other specified conjunctival abnormalities that affect the ocular surface. These ICD-10-CM diagnosis codes are used to document clinical scenarios involving localized or diffuse conjunctival pathology, capturing disease severity, extent of conjunctival involvement, and associated ocular surface effects. Accurate coding within the ICD-10-CM H11 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

Customize your policy alerts

Sign up for ICD-10-CM Code For Other Disorders Of Conjunctiva: Group Overview policy alerts

Get alerted when relevant policies change without checking for updates manually.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

ICD-10-CM H11: Other Disorders Of Conjunctiva Overview

The diagnoses in this group represent inflammatory, degenerative, and other non-infectious and non-traumatic conditions affecting the conjunctiva, the mucous membrane covering the eye and lining the eyelids. These codes target ocular surface disorders such as conjunctival cysts, concretions, and other specified conjunctival abnormalities. Accurate coding matters for reimbursement because it ensures claims reflect the specific ocular condition and its complexity, supporting correct claim adjudication and resource allocation.

When to Use

Use a code from this group when documentation identifies a specific non-infectious, non-traumatic conjunctival disorder such as a conjunctival cyst, concretion, or pannus without concurrent classification elsewhere. Select the code that best matches the documented conjunctival finding, laterality, and any specified descriptors to reflect the clinical situation accurately.

ICD-10-CM Codes

95 rows

ICD-10-CM Code	Description
H11.001	Unspecified pterygium of right eye
H11.002	Unspecified pterygium of left eye
H11.003	Unspecified pterygium of eye, bilateral
H11.009	Unspecified pterygium of unspecified eye
H11.011	Amyloid pterygium of right eye
H11.012	Amyloid pterygium of left eye
H11.013	Amyloid pterygium of eye, bilateral
H11.019	Amyloid pterygium of unspecified eye
H11.021	Central pterygium of right eye
H11.022	Central pterygium of left eye
H11.023	Central pterygium of eye, bilateral
H11.029	Central pterygium of unspecified eye
H11.031	Double pterygium of right eye
H11.032	Double pterygium of left eye
H11.033	Double pterygium of eye, bilateral
H11.039	Double pterygium of unspecified eye
H11.041	Peripheral pterygium, stationary, right eye
H11.042	Peripheral pterygium, stationary, left eye
H11.043	Peripheral pterygium, stationary, bilateral
H11.049	Peripheral pterygium, stationary, unspecified eye

Showing 1–20 of 95

DRG Codes

2 rows

DRG Code	Description
124	Other Disorders of the Eye with MCC or Thrombolytic Agent
125	Other Disorders of the Eye without MCC

Typical Clinical Scenarios

An adult presents to urgent care with sudden onset of red, itchy, and watery eyes over 24 hours after exposure to a friend with seasonal allergies; on exam there is diffuse conjunctival injection and papillary reaction without corneal involvement, consistent with allergic conjunctivitis. A diagnosis from this group is assigned to document the allergic inflammatory process of the conjunctiva and guide topical antihistamine/vasoconstrictor therapy. Typical codes: H11.021, H11.022
An elderly patient with chronic tearing, foreign body sensation, and intermittent mucopurulent discharge is seen in clinic; slit-lamp shows chronic conjunctival scarring and symblepharon formation after previous ocular surface disease. A code from this group is used to capture the chronic conjunctival disorder and scarring that contributes to ongoing ocular surface morbidity and needs monitoring. Typical codes: H11.41, H11.42, H11.43
A patient arrives at the emergency department after a chemical splash to the eye with corneal epithelial defect and extensive conjunctival injection and chemosis; treatment includes irrigation and topical antibiotics. A conjunctival disorder code from this group is assigned as a comorbid ocular surface injury descriptor alongside corneal injury codes to fully document the extent of external eye involvement. Typical codes: H11.33, H11.39

Related Codes

H10-CONJUNCTIVITIS-DISORDERS

ICD-10-CM Code For Conjunctivitis: Group Overview

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Explore openpayer tools

View all tools

When to Use

ICD-10-CM Codes

95 rows

ICD-10-CM Code	Description
H11.001	Unspecified pterygium of right eye
H11.002	Unspecified pterygium of left eye
H11.003	Unspecified pterygium of eye, bilateral
H11.009	Unspecified pterygium of unspecified eye
H11.011	Amyloid pterygium of right eye
H11.012	Amyloid pterygium of left eye
H11.013	Amyloid pterygium of eye, bilateral
H11.019	Amyloid pterygium of unspecified eye
H11.021	Central pterygium of right eye
H11.022	Central pterygium of left eye
H11.023	Central pterygium of eye, bilateral
H11.029	Central pterygium of unspecified eye
H11.031	Double pterygium of right eye
H11.032	Double pterygium of left eye
H11.033	Double pterygium of eye, bilateral
H11.039	Double pterygium of unspecified eye
H11.041	Peripheral pterygium, stationary, right eye
H11.042	Peripheral pterygium, stationary, left eye
H11.043	Peripheral pterygium, stationary, bilateral
H11.049	Peripheral pterygium, stationary, unspecified eye

Showing 1–20 of 95

DRG Codes

2 rows

DRG Code	Description
124	Other Disorders of the Eye with MCC or Thrombolytic Agent
125	Other Disorders of the Eye without MCC

Typical Clinical Scenarios

An adult presents to urgent care with sudden onset of red, itchy, and watery eyes over 24 hours after exposure to a friend with seasonal allergies; on exam there is diffuse conjunctival injection and papillary reaction without corneal involvement, consistent with allergic conjunctivitis. A diagnosis from this group is assigned to document the allergic inflammatory process of the conjunctiva and guide topical antihistamine/vasoconstrictor therapy. Typical codes: H11.021, H11.022
An elderly patient with chronic tearing, foreign body sensation, and intermittent mucopurulent discharge is seen in clinic; slit-lamp shows chronic conjunctival scarring and symblepharon formation after previous ocular surface disease. A code from this group is used to capture the chronic conjunctival disorder and scarring that contributes to ongoing ocular surface morbidity and needs monitoring. Typical codes: H11.41, H11.42, H11.43
A patient arrives at the emergency department after a chemical splash to the eye with corneal epithelial defect and extensive conjunctival injection and chemosis; treatment includes irrigation and topical antibiotics. A conjunctival disorder code from this group is assigned as a comorbid ocular surface injury descriptor alongside corneal injury codes to fully document the extent of external eye involvement. Typical codes: H11.33, H11.39

Related Codes

H10-CONJUNCTIVITIS-DISORDERS

ICD-10-CM Code For Conjunctivitis: Group Overview

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

ICD-10-CM Code For Other Disorders Of Conjunctiva: Group Overview

Sign up for ICD-10-CM Code For Other Disorders Of Conjunctiva: Group Overview policy alerts

ICD-10-CM H11: Other Disorders Of Conjunctiva Overview

ICD-10-CM Code For Other Disorders Of Conjunctiva: Group Overview

Sign up for ICD-10-CM Code For Other Disorders Of Conjunctiva: Group Overview policy alerts

ICD-10-CM H11: Other Disorders Of Conjunctiva Overview

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which ICD-10-CM code group covers non-infectious, non-traumatic conjunctival conditions?

How are laterality and specific conjunctival findings represented in the `H11` group?

Why does accurate coding within `H11` matter for reimbursement?

Which `H11` codes describe pterygium subtypes and their status?

What related DRGs might be associated with diagnoses from the `H11` group?

References

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which ICD-10-CM code group covers non-infectious, non-traumatic conjunctival conditions?

How are laterality and specific conjunctival findings represented in the `H11` group?

Why does accurate coding within `H11` matter for reimbursement?

Which `H11` codes describe pterygium subtypes and their status?

What related DRGs might be associated with diagnoses from the `H11` group?

References