S05.61XA — Penetrating wound without foreign body of right eyeball, initial encounter
S05.61XA is a billable, specific ICD-10-CM code for penetrating wound without foreign body of right eyeball, 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
Excludes2 inherited from the categories above S05.61XA
Also inherited, and the opposite of Excludes1: these conditions are not part of S05.61XA, but a patient can have both, so you may code both.
Other codes that can never be billed with S05.61XA
These codes carry an Excludes1 note pointing at S05.61XA. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S05.61XA alone.
Risk adjustment
S05.61XA 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
S05.61XA is named in 11 Medicare coverage policies — 11 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52438Billing and Coding: Tetanus Immunization
- A54767Billing and Coding: Medicare Preventive Coverage for Certain Vaccines
- A56459Billing and Coding: Debridement Services
- A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Code history
S05.61XA has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share S05.61. If S05.61XA is not quite right, the correct code is usually one of these.
Questions about S05.61XA
- Is S05.61XA a billable ICD-10-CM code?
- Yes. S05.61XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S05.61XA 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).