Is H11.811 a billable ICD-10-CM code?

Yes. H11.811 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does H11.811 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 H11.811?

H11.811 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 H11.811 (H11) and apply to it just the same.

H11.811

H11.811 — Pseudopterygium of conjunctiva, right eye

Billable / specific codeICD-10-CMright

H11.811 is a billable, specific ICD-10-CM code for pseudopterygium of conjunctiva, right eye. It is valid for submission on a claim.

Excludes1 inherited from the categories above H11.811

These are not written on H11.811, but they bind it: a note on a category applies to every code beneath it. Billing H11.811 with anything listed here is a denial.

Written on H11 — Other disorders of conjunctiva

keratoconjunctivitis (H16.2-)

Risk adjustment

H11.811 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

H11.811 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A57068Billing and Coding: Ocular Photography - External

Code history

H11.811 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 H11.81. If H11.811 is not quite right, the correct code is usually one of these.

Questions about H11.811

Is H11.811 a billable ICD-10-CM code?: Yes. H11.811 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does H11.811 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 H11.811?: H11.811 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 H11.811 (H11) and apply to it just the same.