H11.13 ICD-10-CM Code: Conjunctival pigmentations
HCC Buddy Code Card
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FY 2026 Apr update / Diseases of the eye and adnexa (H00-H59) / Disorders of conjunctiva (H10-H11)
H11.13
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceConjunctival pigmentations
Conjunctival pigmentations
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
Official- Conjunctival argyrosis [argyria]
Excludes 2
Official- pseudopterygium (H11.81)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for H11.13 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for H11.13 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for H11.13 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for H11.13 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for H11.13 in this effective period.
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
What This Code Means
H11.13 is the ICD-10-CM diagnosis code for conjunctival pigmentations. H11.13 sits in the ICD-10-CM chapter for diseases of the eye and adnexa (h00-h59), within the section covering disorders of conjunctiva (h10-h11).
Header codes like H11.13 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at H11.13's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for H11.13 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.