S05.91XA (Unspecified injury of right eye and orbit, initial encounter) compared with S05.91XS (Unspecified injury of right eye and orbit, sequela), from the official CMS tabular data. S05.91XA and S05.91XS code the same injury at a different phase of treatment.
Same underlying diagnosis, different encounter phase.
The 7th character records the phase of care for the encounter being coded, so a single encounter takes one of these characters, not several. Review whether both phases belong on the same episode of care.
Source: ICD-10-CM Official Guidelines, Section I.C.19.a
Same injury, other encounter phase. S05.91XA and S05.91XS code the same injury at a different phase of treatment, set by the 7th character.
The 7th character records the type of care given at the encounter being coded (ICD-10-CM Official Guidelines, Section I.C.19.a), so one encounter takes one of these, not both.
| S05.91XAUnspecified injury of right eye and orbit, initial encounter | S05.91XSUnspecified injury of right eye and orbit, sequela | |
|---|---|---|
| Billing status | Billable | 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 | Unspecified injury of right eye and orbit, initial encounter is a billable ICD-10-CM diagnosis code (S05.91A). | Unspecified injury of right eye and orbit, sequela is a billable ICD-10-CM diagnosis code (S05.91S). |
| 7th character | The appropriate 7th character is to be added to each code from category S05 | The appropriate 7th character is to be added to each code from category S05 |
| Includes | open wound of eye and orbit injuries of ear injuries of eye injuries of face [any part] | 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