S91.205A
S91.205A — Unspecified open wound of left lesser toe(s) with damage to nail, initial encounter
Billable / specific codeICD-10-CMleft
S91.205A is a billable, specific ICD-10-CM code for unspecified open wound of left lesser toe(s) with 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 S91
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
S91.205A 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
S91.205A is named in 6 Medicare coverage policies — 6 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
- A56900Billing and Coding: Immunizations
Related codes at this level
Codes that share S91.205. If S91.205A is not quite right, the correct code is usually one of these.
Questions about S91.205A
- Is S91.205A a billable ICD-10-CM code?
- Yes. S91.205A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S91.205A 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).