S00.5 — Superficial injury of lip and oral cavity
S00.5 is a non-billable header ICD-10-CM code for superficial injury of lip and oral cavity. 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
Other codes that can never be billed with S00.5
These codes carry an Excludes1 note pointing at S00.5. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S00.5 alone.
- S01.551Open bite of lip
- S01.551AOpen bite of lip, initial encounter
- S01.551DOpen bite of lip, subsequent encounter
- S01.551SOpen bite of lip, sequela
- S01.552Open bite of oral cavity
- S01.552AOpen bite of oral cavity, initial encounter
- S01.552DOpen bite of oral cavity, subsequent encounter
- S01.552SOpen bite of oral cavity, sequela
Risk adjustment
S00.5 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 S00.5
8 child codes. Green means billable.
- S00.50Unspecified superficial injury of lip and oral cavity
- S00.51Abrasion of lip and oral cavity
- S00.52Blister (nonthermal) of lip and oral cavity
- S00.53Contusion of lip and oral cavity
- S00.54External constriction of lip and oral cavity
- S00.55Superficial foreign body of lip and oral cavity
- S00.56Insect bite (nonvenomous) of lip and oral cavity
- S00.57Other superficial bite of lip and oral cavity
Related codes at this level
Codes that share S00. If S00.5 is not quite right, the correct code is usually one of these.
- S00.0Superficial injury of scalp
- S00.1Contusion of eyelid and periocular area
- S00.2Other and unspecified superficial injuries of eyelid and periocular area
- S00.3Superficial injury of nose
- S00.4Superficial injury of ear
- S00.8Superficial injury of other parts of head
- S00.9Superficial injury of unspecified part of head
Questions about S00.5
- Is S00.5 a billable ICD-10-CM code?
- No. S00.5 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S00.5 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).