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S00.522D vs S06.3

S00.522D (Blister (nonthermal) of oral cavity, subsequent encounter) compared with S06.3 (Focal traumatic brain injury), from the official CMS tabular data.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Summary

These codes should not be reported together because S00.522D’s tabular entry lists S06.3 under Excludes1.

Official rule
What is different?

The conditions named and billing status.S00.522D is “Blister (nonthermal) of oral cavity, subsequent encounter”; S06.3 is “Focal traumatic brain injury”. S06.3 is a non-billable header; S00.522D is billable.

Registry fact

Can these codes be reported together?

No.S00.522D’s entry carries an Excludes1 note covering S06.3: “focal cerebral contusion (S06.3-)”. Both may be reported only when the documentation shows the two conditions are unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

Yes.S00.522D’s tabular entry: “focal cerebral contusion (S06.3-)”. The note covers S06.3.

Official ruleGuide: Excludes1 vs Excludes2

Is one a parent or header code?

One is a header.S06.3 is a non-billable header, but S00.522D is not one of its subdivisions.

Registry fact

Nothing found in 3 other checks; 1 check does not apply
Is there an Excludes2 relationship?

None.Neither entry carries an Excludes2 note that names the other code. S00.522D carries 9 Excludes2 notes and S06.3 carries 11 Excludes2 notes covering other codes; the side-by-side table quotes them.

Official rule

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Excludes1 — generally not reported together

Excludes1 conflict

S00.522D
Blister (nonthermal) of oral cavity, subsequent encounter
↔
S06.3
Focal traumatic brain injury

What we found

No — do not report together.S00.522D carries an Excludes1 note covering S06.3: “focal cerebral contusion (S06.3-)”

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

What to review

Report one of the two. Both may be reported only when the documentation shows the two conditions are unrelated to each other.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes1 note means the two conditions are not ordinarily reported together for the same encounter, because the classification treats them as mutually exclusive forms of the same condition. The documented exception is when the two conditions are unrelated to each other.

Source / rule

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

Official guidance behind these answers

  • Section I.A.12.a — Excludes1 · applies to: Excludes1

    A type 1 Excludes note is a pure excludes note. It means “NOT CODED HERE!” An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. An exception to the Excludes1 definition is the circumstance when the two conditions are unrelated to each other. If it is not clear whether the two conditions involving an Excludes1 note are related or not, query the provider. For example, code F45.8, Other somatoform disorders, has an Excludes1 note for "sleep related teeth grinding (G47.63)," because "teeth grinding" is an inclusion term under F45.8. Only one of these two codes should be assigned for teeth grinding. However psychogenic dysmenorrhea is also an inclusion term under F45.8, and a patient could have both this condition and sleep related teeth grinding. In this case, the two conditions are clearly unrelated to each other, and so it would be appropriate to report F45.8 and G47.63 together.

    ICD-10-CM Official Guidelines FY2027

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

Similar descriptions do not make codes interchangeable. The documentation and the official instructions decide which code applies.

Official descriptionDiffers
S00.522D

Blister (nonthermal) of oral cavity, subsequent encounter

S06.3

Focal traumatic brain injury

StatusDiffers
S00.522D
Billable
S06.3
Non-billable header

A header is not reported on a claim; a code beneath it is.

Report instead: S06.300A, S06.300D, S06.300S, S06.301A, S06.301D

Excludes1Differs
S00.522D
  • diffuse cerebral contusion (S06.2-)
  • focal cerebral contusion (S06.3-)
  • injury of eye and orbit (S05.-)
  • open wound of head (S01.-)
S06.3
  • head injury NOS (S09.90)
Excludes2Differs
Only at S00.522D

No note of its own beyond the shared notes

Only at S06.3
  • any condition classifiable to S06.4-S06.6
  • focal cerebral edema (S06.1)
Shared by both codes (9 notes)
  • burns and corrosions (T20-T32)
  • effects of foreign body in ear (T16)
  • effects of foreign body in larynx (T17.3)
  • effects of foreign body in mouth NOS (T18.0)
  • effects of foreign body in nose (T17.0-T17.1)
  • effects of foreign body in pharynx (T17.2)
  • effects of foreign body on external eye (T15.-)
  • frostbite (T33-T34)
  • insect bite or sting, venomous (T63.4)
Use additional codeDiffers
S00.522D

None at this code

S06.3
  • code, if applicable, for traumatic brain compression or herniation (S06.A-)
  • code, if applicable, to identify mild neurocognitive disorders due to known physiological condition (F06.7-)
Code alsoDiffers
Only at S00.522D

No note of its own beyond the shared notes

Only at S06.3
  • any associated:
  • open wound of head (S01.-)
  • skull fracture (S02.-)
Shared by both codes (1 note)
  • for any associated infection
CategoryDiffers
S00.522D

S00 Superficial injury of head

S06.3

S06 Intracranial injury

ChapterSame for both

S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)

IncludesDiffers
Only at S00.522D

No note of its own beyond the shared notes

Only at S06.3
  • traumatic brain injury
Shared by both codes (12 notes)
  • injuries of ear
  • injuries of eye
  • injuries of face [any part]
  • injuries of gum
  • injuries of jaw
  • injuries of oral cavity
  • injuries of palate
  • injuries of periocular area
  • injuries of scalp
  • injuries of temporomandibular joint area
  • injuries of tongue
  • injuries of tooth
7th characterDiffers
S00.522D
  • The appropriate 7th character is to be added to each code from category S00
S06.3
  • The appropriate 7th character is to be added to each code from category S06, except as noted below

No Code first note at either code.

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on. In a row that differs, each code’s own notes are listed under it, and the notes every code shares are listed once beneath them.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources