Is S00.242 a billable ICD-10-CM code?

No. S00.242 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does S00.242 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).

What cannot be coded together with S00.242?

S00.242 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S00.242 (S00) and apply to it just the same.

S00.242

S00.242 — External constriction of left eyelid and periocular area

Non-billable headerICD-10-CMleft

S00.242 is a non-billable header ICD-10-CM code for external constriction of left eyelid and periocular area. 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 S00

A: initial encounter
D: subsequent encounter
S: sequela

Excludes1 inherited from the categories above S00.242

These are not written on S00.242, but they bind it: a note on a category applies to every code beneath it. Billing S00.242 with anything listed here is a denial.

Written on S00 — Superficial injury of head

diffuse cerebral contusion (S06.2-)
focal cerebral contusion (S06.3-)
injury of eye and orbit (S05.-)
open wound of head (S01.-)

Excludes2 inherited from the categories above S00.242

Also inherited, and the opposite of Excludes1: these conditions are not part of S00.242, but a patient can have both, so you may code both.

Written on S00.2 — Other and unspecified superficial injuries of eyelid and periocular area

superficial injury of conjunctiva and cornea (S05.0-)

Risk adjustment

S00.242 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 history

S00.242 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead S00.242

3 child codes. Green means billable.

Related codes at this level

Codes that share S00.24. If S00.242 is not quite right, the correct code is usually one of these.

Questions about S00.242

Is S00.242 a billable ICD-10-CM code?: No. S00.242 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does S00.242 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).
What cannot be coded together with S00.242?: S00.242 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S00.242 (S00) and apply to it just the same.