S81.852A — Open bite, left lower leg, initial encounter
S81.852A is a billable, specific ICD-10-CM code for open bite, left lower leg, 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
Excludes1 inherited from the categories above S81.852A
These are not written on S81.852A, but they bind it: a note on a category applies to every code beneath it. Billing S81.852A with anything listed here is a denial.
Excludes2 inherited from the categories above S81.852A
Also inherited, and the opposite of Excludes1: these conditions are not part of S81.852A, but a patient can have both, so you may code both.
Risk adjustment
S81.852A 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
S81.852A 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
S81.852A 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 S81.852. If S81.852A is not quite right, the correct code is usually one of these.
Questions about S81.852A
- Is S81.852A a billable ICD-10-CM code?
- Yes. S81.852A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S81.852A 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 S81.852A?
- S81.852A 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 S81.852A (S81.85, S81) and apply to it just the same.