S91.042A
S91.042A — Puncture wound with foreign body, left ankle, initial encounter
Billable / specific codeICD-10-CMleft
S91.042A is a billable, specific ICD-10-CM code for puncture wound with foreign body, left ankle, 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 S91
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
S91.042A 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
S91.042A is named in 11 Medicare coverage policies — 11 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 S91.042. If S91.042A is not quite right, the correct code is usually one of these.
Questions about S91.042A
- Is S91.042A a billable ICD-10-CM code?
- Yes. S91.042A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S91.042A sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the ankle and foot (S90-S99).