S05.20XD — Ocular laceration and rupture with prolapse or loss of intraocular tissue, unspecified eye, subsequent encounter
S05.20XD is a billable, specific ICD-10-CM code for ocular laceration and rupture with prolapse or loss of intraocular tissue, unspecified eye, subsequent encounter. It is valid for submission on a claim.
7th character "D" — subsequent 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
S05.20XD 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
S05.20XD is named in 3 Medicare coverage policies — 3 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
- A56658Billing and Coding: Cosmetic and Reconstructive Surgery
- A56726Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
Related codes at this level
Codes that share S05.20. If S05.20XD is not quite right, the correct code is usually one of these.
Questions about S05.20XD
- Is S05.20XD a billable ICD-10-CM code?
- Yes. S05.20XD is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S05.20XD 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).