S04.012A
S04.012A — Injury of optic nerve, left eye, initial encounter
Billable / specific codeICD-10-CMleft
S04.012A is a billable, specific ICD-10-CM code for injury of optic nerve, left eye, 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 S04
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
S04.012A 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
S04.012A is named in 14 Medicare coverage policies — 14 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
- A54095Billing and Coding: Nerve Conduction Studies and Electromyography
- A56551Billing and Coding: Visual Fields Testing
- A56612Billing and Coding: CT of the Head
Related codes at this level
Codes that share S04.012. If S04.012A is not quite right, the correct code is usually one of these.
Questions about S04.012A
- Is S04.012A a billable ICD-10-CM code?
- Yes. S04.012A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S04.012A 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).