S05.40XD

S05.40XD: Penetrating wound of orbit with or without foreign body, unspecified eye, subsequent encounter

Billable / specific codeICD-10-CMPOA exemptunspecified

S05.40XD is a billable, specific ICD-10-CM code for penetrating wound of orbit with or without foreign body, unspecified eye, subsequent encounter. It is valid for submission on a claim.

Check S05.40XD with the rest of the claim: free scrubber

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

Excludes2 inherited from the categories above S05.40XD

Not part of this code, but both may be coded when both are present.

Written on S05.4: Penetrating wound of orbit with or without foreign body

retained (old) foreign body following penetrating wound in orbit (H05.5-)

Written on S05: Injury of eye and orbit

2nd cranial [optic] nerve injury (S04.0-)
3rd cranial [oculomotor] nerve injury (S04.1-)
open wound of eyelid and periocular area (S01.1-)
orbital bone fracture (S02.1-, S02.3-, S02.8-)
superficial injury of eyelid (S00.1-S00.2)

Other codes that can never be billed with S05.40XD

Their own Excludes1 notes name this code, so the conflict is not listed above.

H44.6Retained (old) intraocular foreign body, magnetic
H44.7Retained (old) intraocular foreign body, nonmagnetic
S00Superficial injury of head

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

S05.40XD is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

Code history

Unchanged in every release from FY2024 to FY2027.