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H11.033

Billable

Double 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 white part of the eye that can affect vision. This code indicates the patient has two pterygiums on each eye (bilateral), meaning both eyes are affected with multiple growths.

Coding Tips

  • Verify documentation specifies 'bilateral' and 'double' pterygium before assigning this code; if only one eye is affected or only one pterygium per eye, use a different H11.03x code
  • This code is specific to bilateral involvement, so confirm both eyes are documented in the clinical record to support accurate coding

Code Hierarchy

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