Is S61.255A a billable ICD-10-CM code?

Yes. S61.255A is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S61.255A sit in the tabular list?

Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the wrist, hand and fingers (S60-S69).

What cannot be coded together with S61.255A?

S61.255A 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 S61.255A (S61.25, S61.2, S61) and apply to it just the same.

S61.255A

S61.255A — Open bite of left ring finger without damage to nail, initial encounter

Billable / specific codeICD-10-CMleft

S61.255A is a billable, specific ICD-10-CM code for open bite of left ring finger without damage to nail, 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 S61

A: initial encounter
D: subsequent encounter
S: sequela

Excludes1 inherited from the categories above S61.255A

These are not written on S61.255A, but they bind it: a note on a category applies to every code beneath it. Billing S61.255A with anything listed here is a denial.

Written on S61.25 — Open bite of finger without damage to nail

superficial bite of finger (S60.46-, S60.47-)

Written on S61.2 — Open wound of other finger without damage to nail

open wound of finger involving nail (matrix) (S61.3-)

Written on S61 — Open wound of wrist, hand and fingers

open fracture of wrist, hand and finger (S62.- with 7th character B)
traumatic amputation of wrist and hand (S68.-)

Excludes2 inherited from the categories above S61.255A

Also inherited, and the opposite of Excludes1: these conditions are not part of S61.255A, but a patient can have both, so you may code both.

Written on S61.2 — Open wound of other finger without damage to nail

open wound of thumb without damage to nail (S61.0-)

Risk adjustment

S61.255A 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

S61.255A is named in 12 Medicare coverage policies — 12 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
A53058Billing and Coding: Home Health Physical Therapy
A53065Billing and Coding: Outpatient Physical Therapy
A54767Billing and Coding: Medicare Preventive Coverage for Certain Vaccines

Code history

S61.255A 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 S61.255. If S61.255A is not quite right, the correct code is usually one of these.

Questions about S61.255A

Is S61.255A a billable ICD-10-CM code?: Yes. S61.255A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S61.255A sit in the tabular list?: Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the wrist, hand and fingers (S60-S69).
What cannot be coded together with S61.255A?: S61.255A 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 S61.255A (S61.25, S61.2, S61) and apply to it just the same.