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 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 S11.85XA (S11.85) and apply to it just the same.

S11.85XA

S11.85XA — Open bite of other specified part of neck, initial encounter

Billable / specific codeICD-10-CM

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

Excludes1 inherited from the categories above S11.85XA

These are not written on S11.85XA, but they bind it: a note on a category applies to every code beneath it. Billing S11.85XA with anything listed here is a denial.

Written on S11.85 — Open bite of other specified part of neck

superficial bite of other specified part of neck (S10.87)

Excludes2 inherited from the categories above S11.85XA

Also inherited, and the opposite of Excludes1: these conditions are not part of S11.85XA, but a patient can have both, so you may code both.

Written on S11 — Open wound of neck

open fracture of vertebra (S12.- with 7th character B)

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

Code history

S11.85XA 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 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 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 S11.85XA (S11.85) and apply to it just the same.