H11.42
Non-Billable

Conjunctival edema

Non-Billable / Non-Specific Code

What is Conjunctival edema?

ICD-10-CM H11.42 is the diagnosis code for Conjunctival edema. This code falls under the section "Disorders of conjunctiva" within Chapter 7 — Diseases of the eye and adnexa (H00-H59). It is a non-billable/non-specific ICD-10-CM code that should not be used for reimbursement. A more specific sub-code is required for billing. Medical coders and healthcare providers use this code to document and classify diagnoses in electronic health records, insurance claims, and clinical databases.

Coding Guidelines for H11.42

Always refer to the official ICD-10-CM Tabular List for complete coding guidelines. Ensure documentation supports the specificity of the code selected. When in doubt, consult a certified medical coder or the latest CMS guidelines.

ICD-10-CM Code Hierarchy

Understanding where H11.42 sits in the ICD-10-CM classification helps ensure proper coding:

Sub-Codes 4 entries
H11.421Conjunctival edema, right eyeBillableH11.422Conjunctival edema, left eyeBillableH11.423Conjunctival edema, bilateralBillableH11.429Conjunctival edema, unspecified eyeBillable
Related Codes

Frequently Asked Questions

Is H11.42 a billable ICD-10-CM code?

No, H11.42 is a non-billable/non-specific code. You should use a more specific sub-code for billing and reimbursement.

What does H11.42 mean?

H11.42 is the ICD-10-CM diagnosis code for "Conjunctival edema". It is used by healthcare providers to classify and document this condition in medical records and insurance claims.

What is the parent code of H11.42?

The parent code of H11.42 is H11.4 ("Other conjunctival vascular disorders and cysts"). H11.42 provides a more specific classification within this category.

What section is H11.42 in?

H11.42 is located in Section H10-H11 — "Disorders of conjunctiva" within Chapter 7 of the ICD-10-CM Tabular List.

What are the sub-codes of H11.42?

H11.42 has 4 sub-code(s) that provide more specific detail: H11.421, H11.422, H11.423, H11.429.

When should I use H11.42?

Use H11.42 when the patients documented diagnosis matches "Conjunctival edema" and the clinical documentation supports this level of specificity. Always verify with the latest ICD-10-CM guidelines and payer requirements.

People Also Ask

What is the ICD-10 code for Conjunctival edema?

The ICD-10-CM code for Conjunctival edema is H11.42.

Can H11.42 be used for primary diagnosis?

No, H11.42 is non-billable. Use a more specific sub-code for primary diagnosis billing.

What chapter is H11.42 in?

H11.42 is in Chapter 7 of the ICD-10-CM Tabular List.

Is H11.42 valid for 2026?

Yes, H11.42 is a valid ICD-10-CM code for the 2026 fiscal year, subject to official CMS updates.

See Also

← PreviousH11.419Vascular abnormalities of conjunctiva, unspecified eyeNext →H11.421Conjunctival edema, right eye
Code Details
H11.42
Conjunctival edema
Non-Billable / Non-Specific Code
7 — Diseases of the eye and adnexa (H00-H59)
H10-H11 — Disorders of conjunctiva
2026 ICD-10-CM