S00.12XA vs S05.1

S00.12XA (Contusion of left eyelid and periocular area, initial encounter) compared with S05.1 (Contusion of eyeball and orbital tissues), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Relationship

Conflict

Excludes1 conflict

S00.12XA

Contusion of left eyelid and periocular area, initial encounter

↔

S05.1

Contusion of eyeball and orbital tissues

Not coded here — these two are mutually exclusive.

“injury of eye and orbit (S05.-)”

An Excludes1 note means the two conditions cannot occur together, so the pair should not be reported for the same encounter. The sole exception is when the conditions are documented as unrelated to each other.

Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a

Informational

Excludes2 relationship

S00.12XA

Contusion of left eyelid and periocular area, initial encounter

↔

S05.1

Contusion of eyeball and orbital tissues

Distinct conditions — both may be reported.

“contusion of eyeball and orbital tissues (S05.1-)”

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source: CMS ICD-10-CM tabular instructional notes

Can these codes be reported together?

No — do not report together. S00.12XA carries an Excludes1 note covering S05.1: “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. S00.12XA carries an Excludes2 note covering S05.1: “contusion of eyeball and orbital tissues (S05.1-)”

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

Side by side

	S00.12XAContusion of left eyelid and periocular area, initial encounter	S05.1Contusion of eyeball and orbital tissues
Billing status	Billable	Non-billable header
Classification	S00-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)
Definition	Contusion of left eyelid and periocular area, initial encounter is a billable ICD-10-CM diagnosis code (S00.12A).	Contusion of eyeball and orbital tissues is a non-billable ICD-10-CM category code (S05.1).
7th character	The appropriate 7th character is to be added to each code from category S00	The 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]

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