S04.011S
S04.011S — Injury of optic nerve, right eye, sequela
Billable / specific codeICD-10-CMPOA exemptright
S04.011S is a billable, specific ICD-10-CM code for injury of optic nerve, right eye, sequela. It is valid for submission on a claim.
7th character "S" — sequela
The appropriate 7th character is to be added to each code from category S04
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
S04.011S 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
S04.011S is named in 15 Medicare coverage policies — 15 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53057Billing and Coding: Home Health Occupational Therapy
- A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
- A53064Billing and Coding: Outpatient Occupational Therapy
- A54095Billing and Coding: Nerve Conduction Studies and Electromyography
Related codes at this level
Codes that share S04.011. If S04.011S is not quite right, the correct code is usually one of these.
Questions about S04.011S
- Is S04.011S a billable ICD-10-CM code?
- Yes. S04.011S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S04.011S 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).