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Compare/S01.1 vs S05

S01.1 vs S05

S01.1 (Open wound of eyelid and periocular area) compared with S05 (Injury of eye and orbit), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).

Can these codes be reported together?

Yes, when both are documented. S01.1 carries an Excludes2 note covering S05: “injury of eye and orbit (S05.-)”

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

Yes, when both are documented. S05 carries an Excludes2 note covering S01.1: “open wound of eyelid and periocular area (S01.1-)”

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

Side by side

S01.1Open wound of eyelid and periocular areaS05Injury of eye and orbit
Billing statusNon-billable header

Report instead: S01.101A, S01.101D, S01.101S, S01.102A, S01.102D

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)
DefinitionOpen wound of eyelid and periocular area is a non-billable ICD-10-CM category code (S01.1).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 S01The 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