Is S31.606S a billable ICD-10-CM code?

Yes. S31.606S is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S31.606S 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 S31.606S?

S31.606S 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 S31.606S (S31) and apply to it just the same.

S31.606S

S31.606S — Unspecified open wound of abdominal wall, right flank with penetration into peritoneal cavity, sequela

Billable / specific codeICD-10-CMPOA exemptright

S31.606S is a billable, specific ICD-10-CM code for unspecified open wound of abdominal wall, right flank with penetration into peritoneal cavity, sequela. It is valid for submission on a claim.

7th character "S" — sequela

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 S31.606S

These are not written on S31.606S, but they bind it: a note on a category applies to every code beneath it. Billing S31.606S 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 S31.606S

Also inherited, and the opposite of Excludes1: these conditions are not part of S31.606S, 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

S31.606S 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

S31.606S is named in 7 Medicare coverage policies — 7 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A53057Billing and Coding: Home Health Occupational Therapy
A53058Billing and Coding: Home Health Physical Therapy
A53064Billing and Coding: Outpatient Occupational Therapy
A53065Billing and Coding: Outpatient Physical Therapy

Code history

What changed, and when. Derived by diffing consecutive CMS release files — which matters when you are defending a code assigned under an earlier edition.

addedFY2024-FY2026
Unspecified open wound of abdominal wall, right flank with penetration into peritoneal cavity, sequela

Related codes at this level

Codes that share S31.606. If S31.606S is not quite right, the correct code is usually one of these.

Questions about S31.606S

Is S31.606S a billable ICD-10-CM code?: Yes. S31.606S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S31.606S 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 S31.606S?: S31.606S 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 S31.606S (S31) and apply to it just the same.