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2025 ICD-10-CM code H11.15

Pinguecula

Use additional codes (H11.151, H11.152, H11.153) to specify laterality.

Medical necessity for treatment is established when the pinguecula causes significant symptoms (e.g., persistent irritation, inflammation, interference with vision or contact lens wear) that warrant intervention.

Diagnosis and management of pingueculae typically fall under the purview of ophthalmologists and optometrists. They conduct eye exams, assess the size and location of the pinguecula, and determine appropriate management strategies.

IMPORTANT:Related codes include H11.151 (right eye), H11.152 (left eye), and H11.153 (bilateral).

In simple words: A pinguecula is a small, raised, yellowish bump on the white of your eye, near the edge of the colored part. It's common, harmless, and often caused by sun exposure.

A pinguecula is a common, benign growth on the conjunctiva, the clear tissue covering the white of the eye. It appears as a yellowish-white, slightly raised mass and is typically located near the cornea, on the nasal or temporal side. Pingueculae are believed to be caused by chronic exposure to sunlight, wind, and dust.

Example 1: A 50-year-old patient presents with a small, yellowish elevation on the nasal side of the conjunctiva in their right eye. The ophthalmologist diagnoses it as a pinguecula., A patient with bilateral pingueculae experiences redness and irritation. The optometrist prescribes lubricating eye drops and advises the patient to wear sunglasses for protection., A patient with a large pinguecula interfering with contact lens wear undergoes surgical removal of the growth.

Documentation should include the location (e.g., right eye, left eye, bilateral), size, and appearance of the pinguecula. Any associated symptoms, such as redness, irritation, or foreign body sensation, should also be documented.

** Excludes1: pingueculitis (H10.81-) and pseudopterygium (H11.81)

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iFrame™ AI's knowledge is aligned with and limited to the materials uploaded by users and should not be interpreted as medical, legal, or any other form of advice by iFrame™.