S00.12XA ICD-10-CM Code: Contusion of left eyelid and periocular area, initial encounter
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Inpatient Payment Groups (MS-DRG)
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.
- MS-DRG 124 — OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT (MDC 02)
- MS-DRG 125 — OTHER DISORDERS OF THE EYE WITHOUT MCC (MDC 02)
- MS-DRG 963 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC (MDC 24)
- MS-DRG 964 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC (MDC 24)
- MS-DRG 965 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC (MDC 24)
A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.
Official Registry Overview & Definition
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for S00.12XA in the official ICD-10-CM tabular list.
Includes
Conditions the official ICD-10-CM tabular list includes under this code.
- injuries of ear
- injuries of eye
- injuries of face [any part]
- injuries of gum
- injuries of jaw
- injuries of oral cavity
- injuries of palate
- injuries of periocular area
- injuries of scalp
- injuries of temporomandibular joint area
- injuries of tongue
- injuries of tooth
Excludes1 — Not Coded Here
Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
- diffuse cerebral contusion (S06.2-) Compare S00.12XA vs S06.2 →
- focal cerebral contusion (S06.3-) Compare S00.12XA vs S06.3 →
- injury of eye and orbit (S05.-) Compare S00.12XA vs S05 →
- open wound of head (S01.-) Compare S00.12XA vs S01 →
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- contusion of eyeball and orbital tissues (S05.1-) Compare S00.12XA vs S05.1 →
- burns and corrosions (T20-T32) Compare S00.12XA vs T20 →
- effects of foreign body in ear (T16) Compare S00.12XA vs T16 →
- effects of foreign body in larynx (T17.3) Compare S00.12XA vs T17.3 →
- effects of foreign body in mouth NOS (T18.0) Compare S00.12XA vs T18.0 →
- effects of foreign body in nose (T17.0-T17.1) Compare S00.12XA vs T17.0 →
- effects of foreign body in pharynx (T17.2) Compare S00.12XA vs T17.2 →
- effects of foreign body on external eye (T15.-) Compare S00.12XA vs T15 →
- frostbite (T33-T34) Compare S00.12XA vs T33 →
- insect bite or sting, venomous (T63.4) Compare S00.12XA vs T63.4 →
Code Also
Additional codes that may be required to fully describe the encounter.
- for any associated infection
Frequently Compared Codes
The official Excludes notes on S00.12XA name these codes. Each comparison page covers when the two can — or must not — be reported together.
Change history
No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.
Verify Before Coding
- No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.
Relationships & Classification
Other codes that name S00.12XA or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.
7 Excludes2 notes across 2 chapters: H00 (via S00.1.-), H00-H05 (via S00.1.-), H01 (via S00.1.-), H02 (via S00.1.-), H04 (via S00.1.-), H05 (via S00.1.-), S05 (via S00.1.-).
1 Code First instructions: R65.1 (via S00.-).
1 Code Also instructions: G96.00 (via S00.-).
Potential MS-DRG Relationships (FY2026)
Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.
Named in the grouper logic of 5 MS-DRGs: DRG 124 (MDC 02), DRG 125 (MDC 02), DRG 963 (MDC 24), DRG 964 (MDC 24), DRG 965 (MDC 24).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Clinical classification (AHRQ CCSR):INJ017 — Superficial injury; contusion, initial encounter (default).
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Related Codes
Same condition, opposite side
Same category and title, differing only in which side of the body is affected.
S00.10XA — Contusion of unspecified eyelid and periocular area, initial encounter (unspecified)Compare S00.12XA vs S00.10XA →, S00.11XA — Contusion of right eyelid and periocular area, initial encounter (right)Compare S00.12XA vs S00.11XA →
Same injury, other encounter phase
Same injury, coded at a different phase of treatment via the 7th character.
S00.12XD — Contusion of left eyelid and periocular area, subsequent encounter Compare S00.12XA vs S00.12XD →, S00.12XS — Contusion of left eyelid and periocular area, sequela Compare S00.12XA vs S00.12XS →
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Superficial injury; contusion, initial encounter).
Lab tests where this diagnosis supports Medicare coverage
Medicare's National Coverage Determinations list this diagnosis as medical justification for these lab tests.
Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)
Contextual Map
Every relationship of S00.12XA in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Hierarchy
- S00-T88 — Chapter 19: Injury, poisoning and certain other consequences of external causes (S00-T88) [Hierarchy]
- S00-S09 — Injuries to the head [Hierarchy]
Referenced by Excludes2 notes
- H00 — Hordeolum and chalazion [Excludes2](via S00.1.-): “superficial injury of eyelid (S00.1-, S00.2-)” · check together
- H00-H05 — Disorders of eyelid, lacrimal system and orbit (H00-H05) [Excludes2](via S00.1.-): “superficial injury of eyelid (S00.1-, S00.2-)” · check together
- H01 — Other inflammation of eyelid [Excludes2](via S00.1.-): “superficial injury of eyelid (S00.1-, S00.2-)” · check together
- H02 — Other disorders of eyelid [Excludes2](via S00.1.-): “superficial injury of eyelid (S00.1-, S00.2-)” · check together
- H04 — Disorders of lacrimal system [Excludes2](via S00.1.-): “superficial injury of eyelid (S00.1-, S00.2-)” · check together
- H05 — Disorders of orbit [Excludes2](via S00.1.-): “superficial injury of eyelid (S00.1-, S00.2-)” · check together
- S05 — Injury of eye and orbit [Excludes2](via S00.1.-): “superficial injury of eyelid (S00.1-S00.2)” · check together
Referenced by Code First instructions
- R65.1 — Systemic inflammatory response syndrome (SIRS) of non-infectious origin [Code First](via S00.-): “injury and trauma (S00-T88)” · check together
Referenced by Code Also instructions
- G96.00 — Cerebrospinal fluid leak, unspecified [Code Also](via S00.-): “head injury (S00-S09)” · check together
Clinical classification (CCSR)
- INJ017 — Superficial injury; contusion, initial encounter [CCSR]
Potential MS-DRG
- DRG 124 — OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT [MS-DRG]: “OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT (MDC 02)”
- DRG 125 — OTHER DISORDERS OF THE EYE WITHOUT MCC [MS-DRG]: “OTHER DISORDERS OF THE EYE WITHOUT MCC (MDC 02)”
- DRG 963 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC (MDC 24)”
- DRG 964 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC (MDC 24)”
- DRG 965 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC (MDC 24)”
MDC crossing · procedures (24157)
- MDC 02 — Diseases and Disorders of the Eye [MDC crossing]: “Diseases and Disorders of the Eye — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
- MDC 24 — Multiple Significant Trauma [MDC crossing]: “Multiple Significant Trauma — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
- 039S0ZX — Drainage of Right Temporal Artery, Open Approach, Diagnostic [Same-MDC procedure]: “Drainage of Right Temporal Artery, Open Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
- 039S4ZX — Drainage of Right Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic [Same-MDC procedure]: “Drainage of Right Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
- 039T0ZX — Drainage of Left Temporal Artery, Open Approach, Diagnostic [Same-MDC procedure]: “Drainage of Left Temporal Artery, Open Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
- 039T4ZX — Drainage of Left Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic [Same-MDC procedure]: “Drainage of Left Temporal Artery, Percutaneous Endoscopic Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
- 03BS0ZX — Excision of Right Temporal Artery, Open Approach, Diagnostic [Same-MDC procedure]: “Excision of Right Temporal Artery, Open Approach, Diagnostic — grouped in MDC 02, the procedure side of this code's crossing.” · check together
- and 24152 more
Nearest codes (40)
- S00 — Superficial injury of head [Sibling]
- S00.05XD — Superficial foreign body of scalp, subsequent encounter [Sibling]
- S00.05XS — Superficial foreign body of scalp, sequela [Sibling]
- S00.06 — Insect bite (nonvenomous) of scalp [Sibling]
- S00.06XA — Insect bite (nonvenomous) of scalp, initial encounter [Sibling]
- S00.06XD — Insect bite (nonvenomous) of scalp, subsequent encounter [Sibling]
- S00.06XS — Insect bite (nonvenomous) of scalp, sequela [Sibling]
- S00.07 — Other superficial bite of scalp [Sibling]
- and 32 more
Frequently Asked Questions (FAQ) & Clinical Guidance
Does S00.12XA require a 7th character?
Yes. The appropriate 7th character is to be added to each code from category S00.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to S00.12XA in its code family, with their registry titles.
- S00.11 — Contusion of right eyelid and periocular area
- S00.11XA — Contusion of right eyelid and periocular area, initial encounter
- S00.11XD — Contusion of right eyelid and periocular area, subsequent encounter
- S00.11XS — Contusion of right eyelid and periocular area, sequela
- S00.12 — Contusion of left eyelid and periocular area
- S00.12XD — Contusion of left eyelid and periocular area, subsequent encounter
- S00.12XS — Contusion of left eyelid and periocular area, sequela
- S00.2 — Other and unspecified superficial injuries of eyelid and periocular area
- S00.20 — Unspecified superficial injury of eyelid and periocular area
- S00.201 — Unspecified superficial injury of right eyelid and periocular area