Is S81.812D a billable ICD-10-CM code?

Yes. S81.812D is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S81.812D 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).

What cannot be coded together with S81.812D?

S81.812D 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 S81.812D (S81) and apply to it just the same.

S81.812D

S81.812D — Laceration without foreign body, left lower leg, subsequent encounter

Billable / specific codeICD-10-CMPOA exemptleft

S81.812D is a billable, specific ICD-10-CM code for laceration without foreign body, left lower leg, subsequent encounter. It is valid for submission on a claim.

7th character "D" — subsequent encounter

The appropriate 7th character is to be added to each code from category S81

A: initial encounter
D: subsequent encounter
S: sequela

Excludes1 inherited from the categories above S81.812D

These are not written on S81.812D, but they bind it: a note on a category applies to every code beneath it. Billing S81.812D with anything listed here is a denial.

Written on S81 — Open wound of knee and lower leg

open fracture of knee and lower leg (S82.-)
traumatic amputation of lower leg (S88.-)

Excludes2 inherited from the categories above S81.812D

Also inherited, and the opposite of Excludes1: these conditions are not part of S81.812D, but a patient can have both, so you may code both.

Written on S81 — Open wound of knee and lower leg

open wound of ankle and foot (S91.-)

Risk adjustment

S81.812D 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

S81.812D is named in 8 Medicare coverage policies — 8 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A53058Billing and Coding: Home Health Physical Therapy
A53065Billing and Coding: Outpatient Physical Therapy
A54767Billing and Coding: Medicare Preventive Coverage for Certain Vaccines
A56459Billing and Coding: Debridement Services

Code history

S81.812D 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 S81.812. If S81.812D is not quite right, the correct code is usually one of these.

Questions about S81.812D

Is S81.812D a billable ICD-10-CM code?: Yes. S81.812D is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S81.812D 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).
What cannot be coded together with S81.812D?: S81.812D 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 S81.812D (S81) and apply to it just the same.