Is S31.05 a billable ICD-10-CM code?

No. S31.05 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does S31.05 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 S31.05?

S31.05 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

S31.05

S31.05 — Open bite of lower back and pelvis

Non-billable headerICD-10-CM

S31.05 is a non-billable header ICD-10-CM code for open bite 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 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

superficial bite of lower back and pelvis (S30.860, S30.870)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Bite of lower back and pelvis NOS

Other codes that can never be billed with S31.05

These codes carry an Excludes1 note pointing at S31.05. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S31.05 alone.

S30.87Other superficial bite of abdomen, lower back, pelvis and external genitals

Risk adjustment

S31.05 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 to one of these instead S31.05

2 child codes. Green means billable.

Related codes at this level

Codes that share S31.0. If S31.05 is not quite right, the correct code is usually one of these.

Questions about S31.05

Is S31.05 a billable ICD-10-CM code?: No. S31.05 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does S31.05 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 S31.05?: S31.05 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.