ICD-10 · PDGM grouping
H11 Other disorders of conjunctiva
All 95 codes in the H11 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
ICD-10-CM FY2027 · CMS grouper v07.2.26
Codes in family
95
Can lead a claim
70
Cannot lead a claim
25
What CMS assigns to H11
70 of the 95 codes group to MMTA - Other; 25 are assigned no clinical group. None of the 95 is assigned a comorbidity subgroup. 70 of the 95 can lead a claim.
Every code in H11
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| H11.0 Pterygium of eye | ||||
| H11.00 Unspecified pterygium of eye | ||||
| H11.001 | Unspecified pterygium of right eye | Can lead a claim | A | None |
| H11.002 | Unspecified pterygium of left eye | Can lead a claim | A | None |
| H11.003 | Unspecified pterygium of eye, bilateral | Can lead a claim | A | None |
| H11.009 | Unspecified pterygium of unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.01 Amyloid pterygium | ||||
| H11.011 | Amyloid pterygium of right eye | Can lead a claim | A | None |
| H11.012 | Amyloid pterygium of left eye | Can lead a claim | A | None |
| H11.013 | Amyloid pterygium of eye, bilateral | Can lead a claim | A | None |
| H11.019 | Amyloid pterygium of unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.02 Central pterygium of eye | ||||
| H11.021 | Central pterygium of right eye | Can lead a claim | A | None |
| H11.022 | Central pterygium of left eye | Can lead a claim | A | None |
| H11.023 | Central pterygium of eye, bilateral | Can lead a claim | A | None |
| H11.029 | Central pterygium of unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.03 Double pterygium of eye | ||||
| H11.031 | Double pterygium of right eye | Can lead a claim | A | None |
| H11.032 | Double pterygium of left eye | Can lead a claim | A | None |
| H11.033 | Double pterygium of eye, bilateral | Can lead a claim | A | None |
| H11.039 | Double pterygium of unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.04 Peripheral pterygium of eye, stationary | ||||
| H11.041 | Peripheral pterygium, stationary, right eye | Can lead a claim | A | None |
| H11.042 | Peripheral pterygium, stationary, left eye | Can lead a claim | A | None |
| H11.043 | Peripheral pterygium, stationary, bilateral | Can lead a claim | A | None |
| H11.049 | Peripheral pterygium, stationary, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.05 Peripheral pterygium of eye, progressive | ||||
| H11.051 | Peripheral pterygium, progressive, right eye | Can lead a claim | A | None |
| H11.052 | Peripheral pterygium, progressive, left eye | Can lead a claim | A | None |
| H11.053 | Peripheral pterygium, progressive, bilateral | Can lead a claim | A | None |
| H11.059 | Peripheral pterygium, progressive, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.06 Recurrent pterygium of eye | ||||
| H11.061 | Recurrent pterygium of right eye | Can lead a claim | A | None |
| H11.062 | Recurrent pterygium of left eye | Can lead a claim | A | None |
| H11.063 | Recurrent pterygium of eye, bilateral | Can lead a claim | A | None |
| H11.069 | Recurrent pterygium of unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.1 Conjunctival degenerations and deposits | ||||
| H11.10 | Unspecified conjunctival degenerations | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.11 Conjunctival deposits | ||||
| H11.111 | Conjunctival deposits, right eye | Can lead a claim | A | None |
| H11.112 | Conjunctival deposits, left eye | Can lead a claim | A | None |
| H11.113 | Conjunctival deposits, bilateral | Can lead a claim | A | None |
| H11.119 | Conjunctival deposits, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.12 Conjunctival concretions | ||||
| H11.121 | Conjunctival concretions, right eye | Can lead a claim | A | None |
| H11.122 | Conjunctival concretions, left eye | Can lead a claim | A | None |
| H11.123 | Conjunctival concretions, bilateral | Can lead a claim | A | None |
| H11.129 | Conjunctival concretions, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.13 Conjunctival pigmentations | ||||
| H11.131 | Conjunctival pigmentations, right eye | Can lead a claim | A | None |
| H11.132 | Conjunctival pigmentations, left eye | Can lead a claim | A | None |
| H11.133 | Conjunctival pigmentations, bilateral | Can lead a claim | A | None |
| H11.139 | Conjunctival pigmentations, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.14 Conjunctival xerosis, unspecified | ||||
| H11.141 | Conjunctival xerosis, unspecified, right eye | Can lead a claim | A | None |
| H11.142 | Conjunctival xerosis, unspecified, left eye | Can lead a claim | A | None |
| H11.143 | Conjunctival xerosis, unspecified, bilateral | Can lead a claim | A | None |
| H11.149 | Conjunctival xerosis, unspecified, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.15 Pinguecula | ||||
| H11.151 | Pinguecula, right eye | Can lead a claim | A | None |
| H11.152 | Pinguecula, left eye | Can lead a claim | A | None |
| H11.153 | Pinguecula, bilateral | Can lead a claim | A | None |
| H11.159 | Pinguecula, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.2 Conjunctival scars | ||||
| H11.21 Conjunctival adhesions and strands (localized) | ||||
| H11.211 | Conjunctival adhesions and strands (localized), right eye | Can lead a claim | A | None |
| H11.212 | Conjunctival adhesions and strands (localized), left eye | Can lead a claim | A | None |
| H11.213 | Conjunctival adhesions and strands (localized), bilateral | Can lead a claim | A | None |
| H11.219 | Conjunctival adhesions and strands (localized), unspecified eyeCMS: Conjunctival adhesions and strands (localized), unsp eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.22 Conjunctival granuloma | ||||
| H11.221 | Conjunctival granuloma, right eye | Can lead a claim | A | None |
| H11.222 | Conjunctival granuloma, left eye | Can lead a claim | A | None |
| H11.223 | Conjunctival granuloma, bilateral | Can lead a claim | A | None |
| H11.229 | Conjunctival granuloma, unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.23 Symblepharon | ||||
| H11.231 | Symblepharon, right eye | Can lead a claim | A | None |
| H11.232 | Symblepharon, left eye | Can lead a claim | A | None |
| H11.233 | Symblepharon, bilateral | Can lead a claim | A | None |
| H11.239 | Symblepharon, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.24 Scarring of conjunctiva | ||||
| H11.241 | Scarring of conjunctiva, right eye | Can lead a claim | A | None |
| H11.242 | Scarring of conjunctiva, left eye | Can lead a claim | A | None |
| H11.243 | Scarring of conjunctiva, bilateral | Can lead a claim | A | None |
| H11.249 | Scarring of conjunctiva, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.3 Conjunctival hemorrhage | ||||
| H11.30 | Conjunctival hemorrhage, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.31 | Conjunctival hemorrhage, right eye | Can lead a claim | A | None |
| H11.32 | Conjunctival hemorrhage, left eye | Can lead a claim | A | None |
| H11.33 | Conjunctival hemorrhage, bilateral | Can lead a claim | A | None |
| H11.4 Other conjunctival vascular disorders and cysts | ||||
| H11.41 Vascular abnormalities of conjunctiva | ||||
| H11.411 | Vascular abnormalities of conjunctiva, right eye | Can lead a claim | A | None |
| H11.412 | Vascular abnormalities of conjunctiva, left eye | Can lead a claim | A | None |
| H11.413 | Vascular abnormalities of conjunctiva, bilateral | Can lead a claim | A | None |
| H11.419 | Vascular abnormalities of conjunctiva, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.42 Conjunctival edema | ||||
| H11.421 | Conjunctival edema, right eye | Can lead a claim | A | None |
| H11.422 | Conjunctival edema, left eye | Can lead a claim | A | None |
| H11.423 | Conjunctival edema, bilateral | Can lead a claim | A | None |
| H11.429 | Conjunctival edema, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.43 Conjunctival hyperemia | ||||
| H11.431 | Conjunctival hyperemia, right eye | Can lead a claim | A | None |
| H11.432 | Conjunctival hyperemia, left eye | Can lead a claim | A | None |
| H11.433 | Conjunctival hyperemia, bilateral | Can lead a claim | A | None |
| H11.439 | Conjunctival hyperemia, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.44 Conjunctival cysts | ||||
| H11.441 | Conjunctival cysts, right eye | Can lead a claim | A | None |
| H11.442 | Conjunctival cysts, left eye | Can lead a claim | A | None |
| H11.443 | Conjunctival cysts, bilateral | Can lead a claim | A | None |
| H11.449 | Conjunctival cysts, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.8 Other specified disorders of conjunctiva | ||||
| H11.81 Pseudopterygium of conjunctiva | ||||
| H11.811 | Pseudopterygium of conjunctiva, right eye | Can lead a claim | A | None |
| H11.812 | Pseudopterygium of conjunctiva, left eye | Can lead a claim | A | None |
| H11.813 | Pseudopterygium of conjunctiva, bilateral | Can lead a claim | A | None |
| H11.819 | Pseudopterygium of conjunctiva, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.82 Conjunctivochalasis | ||||
| H11.821 | Conjunctivochalasis, right eye | Can lead a claim | A | None |
| H11.822 | Conjunctivochalasis, left eye | Can lead a claim | A | None |
| H11.823 | Conjunctivochalasis, bilateral | Can lead a claim | A | None |
| H11.829 | Conjunctivochalasis, unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| H11.89 | Other specified disorders of conjunctiva | Can lead a claim | A | None |
| H11.9 | Unspecified disorder of conjunctiva | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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