2027 ICD-10-CM Diagnosis Code H11.023Central pterygium of eye, bilateral

ICD-10-CM Codes›H00–H59›H10-H11›H11

ICD-10-CM H11.023
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

H11.023 is a billable ICD-10-CM diagnosis code for central pterygium of eye, bilateral. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 124 through 125. Coders also document this condition as bilateral central pterygium of eyes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Cornea and external disease.

Code Identity

ICD-10-CM Code
H11.023
Billable Status
Yes — Valid for Submission
Code Describes
Central pterygium of eye, bilateral
Short Description
Central pterygium of eye, bilateral
Same as the full description in the CMS dataset.
Parent Code
H11.02
Central pterygium of eye

Code Classification

ChapterH00–H59Diseases of the eye and adnexa
SectionH10-H11Disorders of conjunctiva
CategoryH11Other disorders of conjunctiva
This CodeH11.023Central pterygium of eye, bilateral

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Bilateral central pterygium of eyes
  • Central pterygium
  • Central pterygium of left eye
  • Central pterygium of right eye
  • Pterygium of bilateral eyes

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to H11.023: its own notes plus those printed at H11.0, H11, and Chapter 7. A note printed at a category, block or chapter applies to every code under it.

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From H11.0 Pterygium of eye applies to 28 codes
From H11 Other disorders of conjunctiva applies to 95 codes

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Chapter 7 (H00-H59) Diseases of the eye and adnexa applies to 2,677 codes
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury (trauma) of eye and orbit (S05.-)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
  • syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)

Notes

General instructions on how these codes are used.

From Chapter 7 (H00-H59) Diseases of the eye and adnexa applies to 2,677 codes
  • Use an external cause code following the code for the eye condition, if applicable, to identify the cause of the eye condition

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR EYE001
Cornea and external disease
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Eye Diseases

Even if your eyes feel healthy, you could have a problem and not know it. That's why regular eye exams are so important. Refractive errors are the most common type of vision problem that makes it hard to see clearly. But some eye conditions or diseases don't have any symptoms and can lead to a permanent loss of vision.

The full article covers:

  • What diseases can affect the eye?
  • What are the symptoms of eye diseases?
  • Who is more likely to develop eye diseases?
  • What are the treatments for eye diseases?
  • Can eye diseases be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert H11.023 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
372.43 Central pterygium
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About H11.023Overview

What is the ICD-10 code for central pterygium of eye, bilateral?

The ICD-10-CM code for central pterygium of eye, bilateral is H11.023 (sometimes written as H11023). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is H11.023 (Central pterygium of eye) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report central pterygium of eye, bilateral on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does H11.023 group to?

When central pterygium of eye, bilateral is the principal diagnosis on an inpatient stay, it groups to MS-DRG 125, 124, with relative weights from 0.7699 to 1.2470 depending on complications. Higher weights mean higher Medicare reimbursement.

Can H11.023 be reported with a code from H11.81?

Not as a rule. The Excludes1 note at H11.0, which applies to H11.023, lists "pseudopterygium (H11.81-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

What is the ICD-9 equivalent of H11.023?

Under the General Equivalence Mappings, central pterygium of eye, bilateral converts to ICD-9-CM 372.43 (central pterygium). The mapping is approximate, so confirm the match fits the documentation.