S00.12XD vs S05.1
S00.12XD (Contusion of left eyelid and periocular area, subsequent 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.
Can these codes be reported together?
No — do not report together. S00.12XD 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. S00.12XD 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.
Yes, when both are documented. S05.1 carries an Excludes2 note covering S00.12XD: “black eye NOS (S00.1)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Yes, when both are documented. S05.1 carries an Excludes2 note covering S00.12XD: “contusion of eyelid and periocular area (S00.1)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Yes, when both are documented. S05.1 carries an Excludes2 note covering S00.12XD: “superficial injury of eyelid (S00.1-S00.2)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| S00.12XDContusion of left eyelid and periocular area, subsequent encounter | S05.1Contusion of eyeball and orbital tissues | |
|---|---|---|
| Billing status | Billable | Non-billable header Report instead: S05.10XA, S05.10XD, S05.10XS, S05.11XA, S05.11XD |
| 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, subsequent encounter is a billable ICD-10-CM diagnosis code (S00.12D). | 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] |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources