S01.5 vs S02.5
S01.5 (Open wound of lip and oral cavity) compared with S02.5 (Fracture of tooth (traumatic)), 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. S01.5 carries an Excludes1 note covering S02.5: “open skull fracture (S02.- with 7th character B)”
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. S01.5 carries an Excludes2 note covering S02.5: “tooth fracture (S02.5)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| S01.5Open wound of lip and oral cavity | S02.5Fracture of tooth (traumatic) | |
|---|---|---|
| Billing status | Non-billable header Report instead: S01.501A, S01.501D, S01.501S, S01.502A, S01.502D | Non-billable header Report instead: S02.5XXA, S02.5XXB, S02.5XXD, S02.5XXG, S02.5XXK |
| 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 | Open wound of lip and oral cavity is a non-billable ICD-10-CM category code (S01.5). | Fracture of tooth (traumatic) is a non-billable ICD-10-CM category code (S02.5). |
| 7th character | The appropriate 7th character is to be added to each code from category S01 | The appropriate 7th character is to be added to each code from category S02 |
| Includes | injuries of ear injuries of eye injuries of face [any part] injuries of gum | injuries of ear injuries of eye injuries of face [any part] injuries of gum |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources