Is S09.21XA a billable ICD-10-CM code?

Yes. S09.21XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S09.21XA 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).

What cannot be coded together with S09.21XA?

S09.21XA carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S09.21XA (S09.2) and apply to it just the same.

S09.21XA

S09.21XA — Traumatic rupture of right ear drum, initial encounter

Billable / specific codeICD-10-CMright

S09.21XA is a billable, specific ICD-10-CM code for traumatic rupture of right ear drum, 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 S09

A: initial encounter
D: subsequent encounter
S: sequela

Excludes1 inherited from the categories above S09.21XA

These are not written on S09.21XA, but they bind it: a note on a category applies to every code beneath it. Billing S09.21XA with anything listed here is a denial.

Written on S09.2 — Traumatic rupture of ear drum

traumatic rupture of ear drum due to blast injury (S09.31-)

Risk adjustment

S09.21XA 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

S09.21XA is named in 6 Medicare coverage policies — 6 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
A53058Billing and Coding: Home Health Physical Therapy
A56459Billing and Coding: Debridement Services
A56900Billing and Coding: Immunizations

Code history

S09.21XA 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 S09.21. If S09.21XA is not quite right, the correct code is usually one of these.

Questions about S09.21XA

Is S09.21XA a billable ICD-10-CM code?: Yes. S09.21XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S09.21XA 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).
What cannot be coded together with S09.21XA?: S09.21XA carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S09.21XA (S09.2) and apply to it just the same.