S05.40XA — Penetrating wound of orbit with or without foreign body, unspecified eye, initial encounter
S05.40XA is a billable, specific ICD-10-CM code for penetrating wound of orbit with or without foreign body, unspecified 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
S05.40XA 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
S05.40XA is named in 2 Medicare coverage policies — 2 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)
- A57554Billing and Coding: Immune Globulins
Related codes at this level
Codes that share S05.40. If S05.40XA is not quite right, the correct code is usually one of these.
Questions about S05.40XA
- Is S05.40XA a billable ICD-10-CM code?
- Yes. S05.40XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S05.40XA 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).