ICD-10 H11.009
Billable / SpecificUnspecified pterygium of unspecified eye
About ICD-10-CM H11.009
ICD-10-CM code H11.009 represents Unspecified pterygium of unspecified eye. This is a billable/specific code in the Eye and Adnexa chapter (block H11). The 2026 edition of ICD-10-CM H11.009 became effective on October 1, 2025.
Medicare LCD Coverage for H11.009
Local Coverage Determinations (LCDs) from CMS MACs that list H11.009 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing H11.009.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but H11.009 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with H11.009
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert H11.009 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| H11.009 | 37240 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To H11.009
Other codes in section H10-H11 (Disorders of conjunctiva).
ICD-10 H11.009, Billing FAQ
Is ICD-10 code H11.009 billable? +
Yes, H11.009 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What ICD-9 codes does H11.009 map to? +
Per CMS GEMs, H11.009 maps to ICD-9 codes: 37240. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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