ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 H20.11

Billable / Specific

Chronic iridocyclitis, right eye

H20
Block
0
Synonyms
55
LCDs
10
Payer Policies
4
Linked CPTs

About ICD-10-CM H20.11

ICD-10-CM code H20.11 represents Chronic iridocyclitis, right eye. This is a billable/specific code in the Eye and Adnexa chapter (block H20). The 2026 edition of ICD-10-CM H20.11 became effective on October 1, 2025.

Medicare LCD Coverage for H20.11

Local Coverage Determinations (LCDs) from CMS MACs that list H20.11 as a covered diagnosis.

55 LCDs

Showing top 10 of 55 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92201 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92250 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92202 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92227 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92228 →
CMS LCD: Billing and Coding: Off-Label Use of Intravenous Immune Globulin (IVIG)
Article ID: 60187, Effective: , 301 covered, 0 non-covered
CPT J1561 →
CMS LCD: Billing and Coding: Off-Label Use of Intravenous Immune Globulin (IVIG)
Article ID: 60187, Effective: , 301 covered, 0 non-covered
CPT J1556 →
CMS LCD: Billing and Coding: Off-Label Use of Intravenous Immune Globulin (IVIG)
Article ID: 60187, Effective: , 301 covered, 0 non-covered
CPT J1566 →
CMS LCD: Billing and Coding: Off-Label Use of Intravenous Immune Globulin (IVIG)
Article ID: 60187, Effective: , 301 covered, 0 non-covered
CPT J1576 →
CMS LCD: Billing and Coding: Off-Label Use of Intravenous Immune Globulin (IVIG)
Article ID: 60187, Effective: , 301 covered, 0 non-covered
CPT J1554 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing H20.11.

10 policies

5 Medicare

Billing and Coding: Infliximab and biosimilars
Policy ID: ART-52423
Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Policy ID: ART-53060
Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Policy ID: ART-56537
Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
Policy ID: ART-56726
Billing and Coding: Ocular Photography - External
Policy ID: ART-57068

CPT Codes Commonly Billed with H20.11

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

4 linkages
  • J1745 CMS LCD: Billing and Coding: Infliximab and biosimilars CMS LCD
  • Q5104 CMS LCD: Billing and Coding: Infliximab and biosimilars CMS LCD
  • Q5121 CMS LCD: Billing and Coding: Infliximab and biosimilars CMS LCD
  • Q5103 CMS LCD: Billing and Coding: Infliximab and biosimilars CMS LCD

Convert H20.11 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
H20.11 36410 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 H20.11, Billing FAQ

Is ICD-10 code H20.11 billable? +

Yes, H20.11 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with H20.11? +

Procedures frequently paired with H20.11 include: J1745, Q5104, Q5121, Q5103.

What ICD-9 codes does H20.11 map to? +

Per CMS GEMs, H20.11 maps to ICD-9 codes: 36410. 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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