S21.95XA — Open bite of unspecified part of thorax, initial encounter
S21.95XA is a billable, specific ICD-10-CM code for open bite of unspecified part of thorax, 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 S21
- 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 thorax (S20.97)
Excludes1 inherited from the categories above S21.95XA
These are not written on S21.95XA, but they bind it: a note on a category applies to every code beneath it. Billing S21.95XA with anything listed here is a denial.
Risk adjustment
S21.95XA 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
S21.95XA is named in 1 Medicare coverage policy — 1 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
Code history
S21.95XA 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 S21.95. If S21.95XA is not quite right, the correct code is usually one of these.
Questions about S21.95XA
- Is S21.95XA a billable ICD-10-CM code?
- Yes. S21.95XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S21.95XA sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the thorax (S20-S29).
- What cannot be coded together with S21.95XA?
- S21.95XA 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 S21.95XA (S21.95, S21) and apply to it just the same.