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H11.052

Billable

Peripheral pterygium, progressive, left 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 starts at the inner corner and grows toward the pupil. This code indicates the growth is on the left eye and is getting progressively larger over time.

Coding Tips

  • Verify laterality is documented as left eye (OS) in the medical record before assigning this code
  • Confirm the pterygium is noted as 'progressive' or 'advancing' rather than stable; if stability is documented, use H11.051 instead

Code Hierarchy

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