S05 — Injury of eye and orbit
S05 is a non-billable header ICD-10-CM code for injury of eye and orbit. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.
This code requires a 7th character
The appropriate 7th character is to be added to each code from category S05
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Includes
Conditions this code covers.
- open wound of eye and orbit
Other codes that can never be billed with S05
These codes carry an Excludes1 note pointing at S05. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S05 alone.
Risk adjustment
S05 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code to one of these instead S05
10 child codes. Green means billable.
- S05.0Injury of conjunctiva and corneal abrasion without foreign body
- S05.1Contusion of eyeball and orbital tissues
- S05.2Ocular laceration and rupture with prolapse or loss of intraocular tissue
- S05.3Ocular laceration without prolapse or loss of intraocular tissue
- S05.4Penetrating wound of orbit with or without foreign body
- S05.5Penetrating wound with foreign body of eyeball
- S05.6Penetrating wound without foreign body of eyeball
- S05.7Avulsion of eye
- S05.8Other injuries of eye and orbit
- S05.9Unspecified injury of eye and orbit
Questions about S05
- Is S05 a billable ICD-10-CM code?
- No. S05 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S05 sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the head (S00-S09).