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).

What cannot be coded together with S00.5?

S00.5 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 S00.5 (S00) and apply to it just the same.

S00.5

S00.5 — Superficial injury of lip and oral cavity

Non-billable headerICD-10-CM

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

Excludes1 inherited from the categories above S00.5

These are not written on S00.5, but they bind it: a note on a category applies to every code beneath it. Billing S00.5 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.-)

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 history

S00.5 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 S00.5

8 child codes. Green means billable.

Related codes at this level

Codes that share S00. If S00.5 is not quite right, the correct code is usually one of these.

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).
What cannot be coded together with S00.5?: S00.5 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 S00.5 (S00) and apply to it just the same.