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S00.12 vs S05

S00.12 (Contusion of left eyelid and periocular area) compared with S05 (Injury of eye and orbit), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

No — do not report together. S00.12 carries an Excludes1 note covering S05: “injury of eye and orbit (S05.-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Yes, when both are documented. S05 carries an Excludes2 note covering S00.12: “superficial injury of eyelid (S00.1-S00.2)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

S00.12Contusion of left eyelid and periocular areaS05Injury of eye and orbit
Billing statusNon-billable header

Report instead: S00.12XA, S00.12XD, S00.12XS

Non-billable header

Report instead: S05.00XA, S05.00XD, S05.00XS, S05.01XA, S05.01XD

ClassificationS00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
DefinitionContusion of left eyelid and periocular area is a non-billable ICD-10-CM category code (S00.12).Injury of eye and orbit is a non-billable ICD-10-CM category code (S05).
7th characterThe appropriate 7th character is to be added to each code from category S00The appropriate 7th character is to be added to each code from category S05
Includes
injuries of ear
injuries of eye
injuries of face [any part]
injuries of gum
open wound of eye and orbit
injuries of ear
injuries of eye
injuries of face [any part]

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources