S11.85XA — Open bite of other specified part of neck, initial encounter
S11.85XA is a billable, specific ICD-10-CM code for open bite of other specified part of neck, 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
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- superficial bite of other specified part of neck (S10.87)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Bite of other specified part of neck NOS
Risk adjustment
S11.85XA 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
S11.85XA 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
- A53058Billing and Coding: Home Health Physical Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
- A54767Billing and Coding: Medicare Preventive Coverage for Certain Vaccines
Related codes at this level
Codes that share S11.85. If S11.85XA is not quite right, the correct code is usually one of these.
Questions about S11.85XA
- Is S11.85XA a billable ICD-10-CM code?
- Yes. S11.85XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S11.85XA 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).
- What cannot be coded together with S11.85XA?
- S11.85XA carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.