Is S91.25 a billable ICD-10-CM code?

No. S91.25 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does S91.25 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).

What cannot be coded together with S91.25?

S91.25 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

S91.25

S91.25 — Open bite of toe with damage to nail

Non-billable headerICD-10-CM

S91.25 is a non-billable header ICD-10-CM code for open bite of toe with damage to nail. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

The appropriate 7th character is to be added to each code from category S91

A: initial encounter
D: subsequent encounter
S: sequela

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

superficial bite of toe (S90.46-, S90.47-)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Bite of toe with damage to nail NOS

Other codes that can never be billed with S91.25

These codes carry an Excludes1 note pointing at S91.25. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S91.25 alone.

S90.47Other superficial bite of toe

Risk adjustment

S91.25 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.

Code to one of these instead S91.25

7 child codes. Green means billable.

Related codes at this level

Codes that share S91.2. If S91.25 is not quite right, the correct code is usually one of these.

Questions about S91.25

Is S91.25 a billable ICD-10-CM code?: No. S91.25 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does S91.25 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).
What cannot be coded together with S91.25?: S91.25 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.