Is H11.022 a billable ICD-10-CM code?

Yes. H11.022 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does H11.022 sit in the tabular list?

Diseases of the eye and adnexa (H00-H59), in the block Disorders of conjunctiva (H10-H11).

What cannot be coded together with H11.022?

H11.022 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above H11.022 (H11.0, H11) and apply to it just the same.

H11.022

H11.022 — Central pterygium of left eye

Billable / specific codeICD-10-CMleft

H11.022 is a billable, specific ICD-10-CM code for central pterygium of left eye. It is valid for submission on a claim.

Excludes1 inherited from the categories above H11.022

These are not written on H11.022, but they bind it: a note on a category applies to every code beneath it. Billing H11.022 with anything listed here is a denial.

Written on H11.0 — Pterygium of eye

pseudopterygium (H11.81-)

Written on H11 — Other disorders of conjunctiva

keratoconjunctivitis (H16.2-)

Risk adjustment

H11.022 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

H11.022 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

Code history

H11.022 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share H11.02. If H11.022 is not quite right, the correct code is usually one of these.

Questions about H11.022

Is H11.022 a billable ICD-10-CM code?: Yes. H11.022 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does H11.022 sit in the tabular list?: Diseases of the eye and adnexa (H00-H59), in the block Disorders of conjunctiva (H10-H11).
What cannot be coded together with H11.022?: H11.022 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above H11.022 (H11.0, H11) and apply to it just the same.