S05.12XA
S05.12XA — Contusion of eyeball and orbital tissues, left eye, initial encounter
Billable / specific codeICD-10-CMleft
S05.12XA is a billable, specific ICD-10-CM code for contusion of eyeball and orbital tissues, 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 S05
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
S05.12XA 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
S05.12XA is named in 8 Medicare coverage policies — 8 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
- A56459Billing and Coding: Debridement Services
- A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
- A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Related codes at this level
Codes that share S05.12. If S05.12XA is not quite right, the correct code is usually one of these.
Questions about S05.12XA
- Is S05.12XA a billable ICD-10-CM code?
- Yes. S05.12XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S05.12XA 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).