What is the ICD-10 code for pterygium?

The ICD-10 codes for pterygium are H11.051 for the right eye, H11.052 for the left eye, and H11.053 for bilateral cases.

How do you code recurrent pterygium?

Recurrent pterygium is coded as H11.061 for the right eye, H11.062 for the left eye, and H11.063 for bilateral cases.

ICD-10 Coding for Pterygium(H11.051, H11.0, H11.052)

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Learn about the ICD-10 coding for pterygium, including primary and recurrent cases, documentation requirements, and common coding pitfalls.

Also known as:

Surfer's EyeConjunctival Overgrowth

Related ICD-10 Code Ranges

Complete code families applicable to Pterygium

H00-H59Primary Range

Diseases of the eye and adnexa

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Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

Code	Description	When to Use	Key Documentation
H11.051	Pterygium, right eye	Use when documenting pterygium affecting the right eye.	Slit-lamp examination showing pterygium crossing the limbus Photographic evidence if vision-threatening
H11.052	Pterygium, left eye	Use when documenting pterygium affecting the left eye.	Slit-lamp examination showing pterygium crossing the limbus Photographic evidence if vision-threatening
H11.053	Pterygium, bilateral	Use when documenting pterygium affecting both eyes.	Slit-lamp examination showing pterygium crossing the limbus in both eyes Photographic evidence if vision-threatening
H11.061	Recurrent pterygium, right eye	Use when documenting recurrent pterygium affecting the right eye.	Documented history of prior pterygium surgery Slit-lamp examination showing recurrence
H11.062	Recurrent pterygium, left eye	Use when documenting recurrent pterygium affecting the left eye.	Documented history of prior pterygium surgery Slit-lamp examination showing recurrence
H11.063	Recurrent pterygium, bilateral	Use when documenting recurrent pterygium affecting both eyes.	Documented history of prior pterygium surgery Slit-lamp examination showing recurrence in both eyes

Primary ICD-10-CM Codes

Peripheral pterygium, progressive, right eye

H11.051Billable

Differential Codes

Alternative codes to consider when ruling out similar conditions

PingueculaH11.15

Documentation & Coding Risks

Avoid these common issues when documenting Pterygium.

Incomplete documentation of graft type

Impact

Clinical: Inadequate clinical records for future reference., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials or reduced reimbursement.

Mitigation

Use templates to ensure all required elements are documented., Regular training on documentation standards.

Using 65420 for excision with graft

Impact

Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on surgical procedures.

Mitigation

Use 65426 for excision with any graft type.

Omitting laterality in ICD-10 coding

Impact

Reimbursement: Claims may be denied for lack of specificity., Compliance: Failure to meet ICD-10 coding standards., Data Quality: Inaccurate patient records.

Mitigation

Always append the correct laterality digit.

Incorrect use of procedure codes

Impact

Using incorrect codes for pterygium procedures can lead to audits.

Mitigation

Regular coding audits and staff training.

Frequently Asked Questions

Documentation requirements, coding pitfalls and FAQs for conditions coded with H11.051.

Primary Code

H11.051

Peripheral pterygium, progressive, right eye

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ICD-10 codes9

Coding risks4

FAQs2

ICD-10 Coding for Pterygium(H11.051, H11.0, H11.052)

Documentation & Coding Risks

Frequently Asked Questions

What is the ICD-10 code for pterygium?

How do you code recurrent pterygium?

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