Is S31.542A a billable ICD-10-CM code?

Yes. S31.542A is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S31.542A 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 S31.542A?

S31.542A 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 S31.542A (S31.5, S31) and apply to it just the same.

S31.542A

S31.542A — Puncture wound with foreign body of unspecified external genital organs, female, initial encounter

Billable / specific codeICD-10-CM

S31.542A is a billable, specific ICD-10-CM code for puncture wound with foreign body of unspecified external genital organs, female, 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 S31

A: initial encounter
D: subsequent encounter
S: sequela

Excludes1 inherited from the categories above S31.542A

These are not written on S31.542A, but they bind it: a note on a category applies to every code beneath it. Billing S31.542A with anything listed here is a denial.

Written on S31.5 — Open wound of unspecified external genital organs

traumatic amputation of external genital organs (S38.21, S38.22)

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 S31.542A

Also inherited, and the opposite of Excludes1: these conditions are not part of S31.542A, 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

S31.542A 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

S31.542A 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

S31.542A 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 S31.542. If S31.542A is not quite right, the correct code is usually one of these.

Questions about S31.542A

Is S31.542A a billable ICD-10-CM code?: Yes. S31.542A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S31.542A 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 S31.542A?: S31.542A 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 S31.542A (S31.5, S31) and apply to it just the same.