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H11.021

Billable

Central pterygium of right eye

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 white part of the eye that extends toward the cornea (the clear front part of the eye). This code specifically refers to a pterygium located in the central area of the right eye.

Coding Tips

  • Verify laterality is documented as right eye; if bilateral pterygia are present, code both H11.021 (right) and H11.022 (left) separately
  • Confirm whether the pterygium is affecting vision or causing symptoms, as this may influence treatment decisions and documentation specificity

Code Hierarchy

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