S11.20XA
S11.20XA — Unspecified open wound of pharynx and cervical esophagus, initial encounter
Billable / specific codeICD-10-CM
S11.20XA is a billable, specific ICD-10-CM code for unspecified open wound of pharynx and cervical esophagus, 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 S11
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
S11.20XA 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
S11.20XA is named in 8 Medicare coverage policies — 8 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53058Billing and Coding: Home Health Physical Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
- A54767Billing and Coding: Medicare Preventive Coverage for Certain Vaccines
- A56389Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
Related codes at this level
Codes that share S11.20. If S11.20XA is not quite right, the correct code is usually one of these.
Questions about S11.20XA
- Is S11.20XA a billable ICD-10-CM code?
- Yes. S11.20XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S11.20XA sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the neck (S10-S19).