T26.31XA (Burns of other specified parts of right eye and adnexa, initial encounter) compared with T26.31XS (Burns of other specified parts of right eye and adnexa, sequela), from the official CMS tabular data. T26.31XA and T26.31XS code the same injury at a different phase of treatment. MedCoder-derived
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. T26.31XA and T26.31XS 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.
| T26.31XABurns of other specified parts of right eye and adnexa, initial encounter | T26.31XSBurns of other specified parts of right eye and adnexa, 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 | Burns of other specified parts of right eye and adnexa, initial encounter is a billable ICD-10-CM diagnosis code (T26.31XA). | Burns of other specified parts of right eye and adnexa, sequela is a billable ICD-10-CM diagnosis code (T26.31XS). |
| 7th character | The appropriate 7th character is to be added to each code from category T26 | The appropriate 7th character is to be added to each code from category T26 |
| Use additional code | external cause code to identify the source, place and intent of the burn (X00-X19, X75-X77, X96-X98, Y92) | external cause code to identify the source, place and intent of the burn (X00-X19, X75-X77, X96-X98, Y92) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources