S00.542A
S00.542A — External constriction of oral cavity, initial encounter
Billable / specific codeICD-10-CM
S00.542A is a billable, specific ICD-10-CM code for external constriction of oral cavity, initial encounter. It is valid for submission on a claim.
7th character "A" — initial encounter
The appropriate 7th character is to be added to each code from category S00
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
S00.542A 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.
Medicare coverage
S00.542A is named in 5 Medicare coverage policies — 5 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52438Billing and Coding: Tetanus Immunization
- A53058Billing and Coding: Home Health Physical Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
- A56459Billing and Coding: Debridement Services
Related codes at this level
Codes that share S00.542. If S00.542A is not quite right, the correct code is usually one of these.
Questions about S00.542A
- Is S00.542A a billable ICD-10-CM code?
- Yes. S00.542A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S00.542A 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).