S81.011A
S81.011A — Laceration without foreign body, right knee, initial encounter
Billable / specific codeICD-10-CMright
S81.011A is a billable, specific ICD-10-CM code for laceration without foreign body, right knee, 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 S81
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
S81.011A 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
S81.011A 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
Related codes at this level
Codes that share S81.011. If S81.011A is not quite right, the correct code is usually one of these.
Questions about S81.011A
- Is S81.011A a billable ICD-10-CM code?
- Yes. S81.011A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S81.011A sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the knee and lower leg (S80-S89).