Is S31.03 a billable ICD-10-CM code?

No. S31.03 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does S31.03 sit in the tabular list?

Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals (S30-S39).

What cannot be coded together with S31.03?

S31.03 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 S31.03 (S31) and apply to it just the same.

S31.03

S31.03 — Puncture wound without foreign body of lower back and pelvis

Non-billable headerICD-10-CM

S31.03 is a non-billable header ICD-10-CM code for puncture wound without foreign body of lower back and pelvis. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

The appropriate 7th character is to be added to each code from category S31

A: initial encounter
D: subsequent encounter
S: sequela

Excludes1 inherited from the categories above S31.03

These are not written on S31.03, but they bind it: a note on a category applies to every code beneath it. Billing S31.03 with anything listed here is a denial.

Written on S31 — Open wound of abdomen, lower back, pelvis and external genitals

traumatic amputation of part of abdomen, lower back and pelvis (S38.2-, S38.3)

Excludes2 inherited from the categories above S31.03

Also inherited, and the opposite of Excludes1: these conditions are not part of S31.03, but a patient can have both, so you may code both.

Written on S31 — Open wound of abdomen, lower back, pelvis and external genitals

open wound of hip (S71.00-S71.02)
open fracture of pelvis (S32.1--S32.9 with 7th character B)

Risk adjustment

S31.03 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.

Code history

S31.03 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead S31.03

2 child codes. Green means billable.

Related codes at this level

Codes that share S31.0. If S31.03 is not quite right, the correct code is usually one of these.

Questions about S31.03

Is S31.03 a billable ICD-10-CM code?: No. S31.03 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does S31.03 sit in the tabular list?: Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals (S30-S39).
What cannot be coded together with S31.03?: S31.03 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 S31.03 (S31) and apply to it just the same.