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H11.013

Billable

Amyloid pterygium of eye, bilateral

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

A pterygium is a growth of tissue on the eye's surface, and in this case, the growth is made of amyloid protein deposits and affects both eyes. This is a rare condition where abnormal protein accumulates in the wing-shaped tissue that grows across the cornea.

Coding Tips

  • Verify that the pterygium is confirmed to be amyloid type through pathology or clinical documentation before coding H11.013, as this is a specific histological diagnosis
  • Ensure bilateral involvement is documented in the medical record; if only one eye is affected, use H11.011 (right eye) or H11.012 (left eye) instead

Code Hierarchy

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