S02.1 vs S05.91XA
S02.1 (Fracture of base of skull) compared with S05.91XA (Unspecified injury of right eye and orbit, initial encounter), 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. S05.91XA carries an Excludes2 note covering S02.1: “orbital bone fracture (S02.1-, S02.3-, S02.8-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| S02.1Fracture of base of skull | S05.91XAUnspecified injury of right eye and orbit, initial encounter | |
|---|---|---|
| Billing status | Non-billable header Report instead: S02.101A, S02.101B, S02.101D, S02.101G, S02.101K | Billable |
| 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 | Fracture of base of skull is a non-billable ICD-10-CM category code (S02.1). | Unspecified injury of right eye and orbit, initial encounter is a billable ICD-10-CM diagnosis code (S05.91A). |
| 7th character | The appropriate 7th character is to be added to each code from category S02 | 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