H11.012
H11.012 — Amyloid pterygium of left eye
Billable / specific codeICD-10-CMleft
H11.012 is a billable, specific ICD-10-CM code for amyloid pterygium of left eye. It is valid for submission on a claim.
Risk adjustment
H11.012 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
H11.012 is named in 3 Medicare coverage policies — 3 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
- A56816Billing and Coding: Computerized Corneal Topography
- A57068Billing and Coding: Ocular Photography - External
Related codes at this level
Codes that share H11.01. If H11.012 is not quite right, the correct code is usually one of these.
Questions about H11.012
- Is H11.012 a billable ICD-10-CM code?
- Yes. H11.012 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does H11.012 sit in the tabular list?
- Diseases of the eye and adnexa (H00-H59), in the block Disorders of conjunctiva (H10-H11).