S04.0 vs S05.92XD
S04.0 (Injury of optic nerve and pathways) compared with S05.92XD (Unspecified injury of left eye and orbit, subsequent 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. S05.92XD carries an Excludes2 note covering S04.0: “2nd cranial [optic] nerve injury (S04.0-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| S04.0Injury of optic nerve and pathways | S05.92XDUnspecified injury of left eye and orbit, subsequent encounter | |
|---|---|---|
| Billing status | Non-billable header Report instead: S04.011A, S04.011D, S04.011S, S04.012A, S04.012D | 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 | Injury of optic nerve and pathways is a non-billable ICD-10-CM category code (S04.0). | Unspecified injury of left eye and orbit, subsequent encounter is a billable ICD-10-CM diagnosis code (S05.92D). |
| 7th character | The appropriate 7th character is to be added to each code from category S04 | 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] |
| Use additional code | code to identify any visual field defect or blindness (H53.4-, H54.-) | — |
| Code first | any associated intracranial injury (S06.-) | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources