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2025 ICD-10-CM code H11.151

Pinguecula of the right eye.

Use H11.152 for left eye, and H11.153 for bilateral pingueculae. Do not use H11.151 if the pinguecula is inflamed (pingueculitis), which is coded as H10.811.

Medical necessity for treatment is usually driven by patient symptoms, such as irritation, foreign body sensation, or cosmetic concerns. Treatment of asymptomatic pingueculae is generally not medically necessary.

In simple words: A pinguecula is a small, harmless bump on the white of your right eye. It's common and usually doesn't cause any problems.

A pinguecula is a common, benign growth on the conjunctiva, the clear membrane that covers the white part of the eye and the inner surface of the eyelids. It appears as a yellowish-white, slightly raised mass, typically located on the nasal side of the conjunctiva. This code specifies its presence in the right eye.

Example 1: A 50-year-old patient presents with a small, yellowish elevation on the nasal side of the conjunctiva of their right eye. It is asymptomatic and diagnosed as a pinguecula., A patient with a history of pingueculae in both eyes reports mild irritation in their right eye. Upon examination, the right pinguecula appears slightly inflamed, possibly due to environmental factors. This would still be coded as H11.151, as inflammation is considered inherent to the condition., A patient undergoes a routine eye exam and a small pinguecula is noted on their right eye. The patient is asymptomatic and the pinguecula is not inflamed. This is an incidental finding and would be coded as H11.151.

Clinical documentation should describe the location (right eye), size, and appearance of the pinguecula. If inflamed, the associated symptoms should also be noted. If there's diagnostic uncertainty, any additional tests or procedures to rule out other conditions should be recorded.

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