MCMedicalCodingSoftware
Free trial
H11.043

H11.043: Peripheral pterygium, stationary, bilateral

Billable / specific codeICD-10-CMbilateral

H11.043 is a billable, specific ICD-10-CM code for peripheral pterygium, stationary, bilateral. It is valid for submission on a claim.

Check H11.043 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above H11.043

A category’s note binds every code beneath it.

Written on H11.0: Pterygium of eye

Written on H11: Other disorders of conjunctiva

  • keratoconjunctivitis (H16.2-)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

H11.043 is named in 3 Medicare coverage policies: 3 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

  • A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
  • A56816Billing and Coding: Computerized Corneal Topography
  • A57068Billing and Coding: Ocular Photography - External

Code history

Unchanged in every release from FY2024 to FY2027.

Other codes under H11.04

ICD-10-CMFY2027· effective October 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release: see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.