Is S01.5 a billable ICD-10-CM code?

No. S01.5 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does S01.5 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).

S01.5

S01.5 — Open wound of lip and oral cavity

Non-billable headerICD-10-CM

S01.5 is a non-billable header ICD-10-CM code for open wound 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 S01

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.

tooth dislocation (S03.2)
tooth fracture (S02.5)

Other codes that can never be billed with S01.5

These codes carry an Excludes1 note pointing at S01.5. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S01.5 alone.

S00.571Other superficial bite of lip
S00.571AOther superficial bite of lip, initial encounter
S00.571DOther superficial bite of lip, subsequent encounter
S00.571SOther superficial bite of lip, sequela
S00.572Other superficial bite of oral cavity
S00.572AOther superficial bite of oral cavity, initial encounter
S00.572DOther superficial bite of oral cavity, subsequent encounter
S00.572SOther superficial bite of oral cavity, sequela

Risk adjustment

S01.5 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 S01.5

6 child codes. Green means billable.

Related codes at this level

Codes that share S01. If S01.5 is not quite right, the correct code is usually one of these.

Questions about S01.5

Is S01.5 a billable ICD-10-CM code?: No. S01.5 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does S01.5 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).