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S01.159 ICD-10-CM Code: Open bite of unspecified eyelid and periocular area

Compare with another code for S01.159Check this code on a claim

Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Coding at a Glance

7th character
Required — see the character table on this page
Tabular directives
12 inclusion terms · 2 Excludes1 · 11 Excludes2 · 6 code-also instructions

Not billable · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

7th character:required: report a code with a 7th character· The appropriate 7th character is to be added to each code from category S01See the 7th character note

Excludes1Not reported with this code unless documented as unrelated
  • superficial bite of eyelid and periocular area (S00.26, S00.27) (from S01.15)
  • open skull fracture (S02.- with 7th character B) (from S01)
Code alsoMay be needed with this code
  • any associated: (from S01)
  • injury of cranial nerve (S04.-) (from S01)
  • injury of muscle and tendon of head (S09.1-) (from S01)
  • intracranial injury (S06.-) (from S01)

+2 more in Instructions

Excludes2Not included here; may be reported together
  • injury of eye and orbit (S05.-) (from S01)
  • traumatic amputation of part of head (S08.-) (from S01)
  • burns and corrosions (T20-T32) (from S00-S09)
  • effects of foreign body in ear (T16) (from S00-S09)

+7 more in Instructions

Includesfrom S00-S09What S00-S09 covers
  • injuries of ear
  • injuries of eye
  • injuries of face [any part]
  • injuries of gum

+8 more in Instructions

Where it sits Source: CMS/NCHS

Under:Chapter 19: Injury, Poisoning and Certain Other Consequences of External CausesS00-S09 Injuries to the headS01 Open wound of headS01.1 Open wound of eyelid and periocular areaS01.15 Open bite of eyelid and periocular area

Codes under S01.159 (3)

  • S01.159AOpen bite of unspecified eyelid and periocular area, initial encounterBillable
  • S01.159DOpen bite of unspecified eyelid and periocular area, subsequent encounterBillable
  • S01.159SOpen bite of unspecified eyelid and periocular area, sequelaBillable

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for S01.159 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on S01.159 itself; “inherited from” names the category or block whose note applies here.

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

Source: inherited from S00-S09

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).

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Code Also

Additional codes that may be required to fully describe the encounter.

  • any associated:
  • injury of cranial nerve (S04.-) inherited from S01
  • injury of muscle and tendon of head (S09.1-) inherited from S01
  • intracranial injury (S06.-) inherited from S01
  • wound infection inherited from S01
  • for any associated infection inherited from S00-S09

7th Character Guide

"The appropriate 7th character is to be added to each code from category S01"

  • A — initial encounter
  • D — subsequent encounter
  • S — sequela

How the encounter character is assigned. “Initial encounter” means the patient is receiving active treatment for the condition — it is not limited to the first visit, and a different or new provider giving active treatment still assigns it. “Subsequent encounter” covers care during the healing or recovery phase after active treatment. “Sequela” is for complications or conditions that arise as a direct result of the original condition.

ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.19.a (paraphrased by MedCoder).

Variant codes in this family

S01.159A, S01.159D, S01.159S

Character meanings are CMS's official 7th-character extensions for this family, as carried in each variant code's official description; variant codes are registry rows. The explanation of how the encounter character is assigned is MedCoder editorial, distinct from the official content above it.

Coder workflow for S01.159

MedCoder structured workflow — derived from this code’s own official record

Before you code S01.159

  1. S01.159 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewS01.159A, S01.159D, S01.159S

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. A 7th character is required in this family. Confirm the documented encounter: initial (active treatment), subsequent (healing or recovery phase), or sequela. S01.159 is not valid without one. “Initial” means active treatment, not the first visit (Guidelines I.C.19.a).

    See the 7th Character Guide · Guide: 7th characters: initial, subsequent, sequela →

  3. Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: unspecified). The unspecified-side code applies only when the record states no side. Laterality is assigned from the documented side; where a bilateral code exists and both sides are documented, it is used instead of two unilateral codes (Guidelines I.B.13).

    ReviewS01.151 · right, S01.152 · left

    Guide: Laterality coding →

  4. Confirm the injury type, the anatomical site at the most specific level documented, laterality where the family codes it, and the encounter for the 7th character. Each injury is coded separately unless the classification provides a combination code, and a superficial injury is not coded when a more severe injury of the same site is documented. Injury chapter guidelines (Guidelines I.C.19.b, I.C.19.b.1).

    Guide: 7th characters: initial, subsequent, sequela →

  5. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with the code beneath S01.159. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support one of the more specific codes beneath S01.159?
    Yes → Select that code and continue the checks below on its own page.
    No → S01.159 cannot be reported as written. Where the codes beneath it include an unspecified code, that code applies when the record goes no further; otherwise query for the missing detail.

    ReviewS01.159A, S01.159D, S01.159S

  2. Does the documentation support a condition named in S01.159’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewS00.26, S00.27, S02

  3. Is the side documented?
    Yes → Select the code for the documented side (or the bilateral code when both sides are documented and one exists).
    No → Use the unspecified-side code only when the record states no side; a query is the alternative.

    ReviewS01.151 · right, S01.152 · left

  4. Is the encounter phase documented — active treatment, healing or recovery, or a sequela?
    Yes → Assign the matching 7th character; the variant codes are in the 7th Character Guide.
    No → The code is invalid without its 7th character — query for the missing element.

Report the code beneath S01.159 that the documentation supports, not S01.159 itself. Then review the Code Also note, and confirm that code is valid for the date of service on its own page.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Anatomical site
At the most specific level the record states; a site the classification separates cannot be assumed from a procedure or a measurement.
Laterality
Right, left or bilateral as documented; unspecified only when the record states no side (Guidelines I.B.13).
Encounter type
Active treatment, healing or recovery phase, or sequela — the basis of the 7th character (Guidelines I.C.19.a).
Open or closed; displaced or nondisplaced
Defaults apply when the record is silent: closed, and displaced (Guidelines I.C.19.c).
External cause, place and activity
For the external cause codes reported with the injury or poisoning, where documented (Guidelines I.C.20.a).
Any detail beyond this code’s title
What the record states that a more specific code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

  • Excludes1 — check before selecting S01.159(2 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with S01.159: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareS00.26, S00.27, S02

    See the official tabular notes · Guidelines I.A.12.a

  • Excludes2 — not part of S01.159(11 notes)

    Coding workflow: The conditions named in this note are not included in S01.159. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareS05, S08, T16, T17.3, T18.0, T17.2

    See the official tabular notes · Guidelines I.A.12.b

  • Code Also — related condition(6 notes)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    ReviewS04, S09.1, S06

    See the official tabular notes · Guidelines I.A.17

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: The provider documents the condition in the terms of this code’s title and records no further detail.

Coding question: Is a more specific sibling code supportable?

Path: Review the specific siblings in this subcategory and what each requires the record to state.

Reason: A more specific code needs documentation of the distinguishing element; without it the unspecified code is appropriate, and a provider query is the route to specificity (Guidelines I.A.9.b, I.B.18).

ReviewS01.151, S01.152

Documentation: Both the condition S01.159 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewS00.26, S00.27, S02

Documentation: The patient returns during the healing or recovery phase after active treatment of the same condition.

Coding question: Which 7th character applies?

Path: Review the official 7th-character definitions for this family in the 7th Character Guide.

Reason: “Initial encounter” means active treatment, not the first visit; care during recovery takes “subsequent encounter”, and a complication arising from the original condition takes “sequela” (Guidelines I.C.19.a).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse S01.159 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of S01.159 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • S00.26— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of superficial bite of eyelid and periocular area moves the case to S00.26; the two are not reported together unless documented as unrelated.

    Full comparison: S01.159 vs S00.26 →

  • S00.27— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of superficial bite of eyelid and periocular area moves the case to S00.27; the two are not reported together unless documented as unrelated.

    Full comparison: S01.159 vs S00.27 →

  • S02— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of open skull fracture moves the case to S02; the two are not reported together unless documented as unrelated.

    Full comparison: S01.159 vs S02 →

  • S01.151— Laterality relationship (Review)

    Same condition; these differ only in which side is documented.

    The same condition with a different side named (the opposite side, both sides, or none); the documented side decides, and a bilateral code, where one exists, replaces the pair when both sides are documented.

    What moves you there: A documented right side moves the case to S01.151.

    Full comparison: S01.159 vs S01.151 →

  • S01.152— Laterality relationship (Review)

    Same condition; these differ only in which side is documented.

    The same condition with a different side named (the opposite side, both sides, or none); the documented side decides, and a bilateral code, where one exists, replaces the pair when both sides are documented.

    What moves you there: A documented left side moves the case to S01.152.

    Full comparison: S01.159 vs S01.152 →

  • S01.159A— Encounter relationship (Review)

    Same underlying diagnosis, different encounter phase.

    The same diagnosis at a different phase of care; one encounter takes one 7th character.

    What moves you there: Documentation of a initial encounter moves the case to S01.159A.

    Full comparison: S01.159 vs S01.159A →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Open bite of unspecified eyelid and periocular area is a non-billable ICD-10-CM category code (S01.159). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. A 7th character applies in this family. Confirm the documented encounter matches the character assigned. See the official 7th-character definitions and this code’s variants
  2. 6 Code Also notes — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  3. 2 Excludes1 entries — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  4. 11 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name S01.159 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.

Referenced by 1 Excludes1 note: S00 — Superficial injury of head (via S01.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 8 Excludes2 notes across 2 chapters: H00 — Hordeolum and chalazion (via S01.1.-), H00-H05 — Disorders of eyelid, lacrimal system and orbit (H00-H05) (via S01.1.-), H01 — Other inflammation of eyelid (via S01.1.-), H02 — Other disorders of eyelid (via S01.1.-), H04 — Disorders of lacrimal system (via S01.1.-), H05 — Disorders of orbit (via S01.1.-), S05 — Injury of eye and orbit (via S01.1.-), T15 — Foreign body on external eye (via S01.1.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 6 Code Also instructions across 2 chapters: G96.00 — Cerebrospinal fluid leak, unspecified (via S01.-), G96.08 — Other cranial cerebrospinal fluid leak (via S01.-), G96.09 — Other spinal cerebrospinal fluid leak (via S01.-), S04 — Injury of cranial nerve (via S01.-), S06 — Intracranial injury (via S01.-), S09.1 — Injury of muscle and tendon of head (via S01.-).

These codes suggest coding this condition alongside when both are present.

Related Codes

Same condition, different side

Same title, differing only in which side of the body it names: right, left, bilateral or unspecified.

S01.151 — Open bite of right eyelid and periocular area (right)Compare S01.159 vs S01.151 →, S01.152 — Open bite of left eyelid and periocular area (left)Compare S01.159 vs S01.152 →

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Bite”; these codes share that main term but sit in a different category of the Tabular List.

S00.46 — Insect bite (nonvenomous) of ear (ear, superficial NEC, insect), S00.47 — Other superficial bite of ear (ear, superficial NEC), S00.561 — Insect bite (nonvenomous) of lip (lip, superficial NEC, insect), S00.562 — Insect bite (nonvenomous) of oral cavity (oral cavity, superficial NEC, insect), S00.571 — Other superficial bite of lip (lip, superficial NEC), S00.572 — Other superficial bite of oral cavity (oral cavity, superficial NEC), S00.86 — Insect bite (nonvenomous) of other part of head (cheek, superficial NEC, insect), S00.87 — Other superficial bite of other part of head (cheek, superficial NEC), S00.96 — Insect bite (nonvenomous) of unspecified part of head (head, superficial NEC, insect), S00.97 — Other superficial bite of unspecified part of head (head, superficial NEC), S10.16 — Insect bite (nonvenomous) of throat (larynx, superficial NEC, insect), S10.17 — Other superficial bite of throat (larynx, superficial NEC), S10.86 — Insect bite of other specified part of neck (thyroid, superficial NEC, insect), S10.87 — Other superficial bite of other specified part of neck (thyroid, superficial NEC), S10.96 — Insect bite of unspecified part of neck (neck, superficial NEC, insect), S10.97 — Other superficial bite of unspecified part of neck (neck, superficial NEC), S11.015 — Open bite of larynx (larynx), S11.025 — Open bite of trachea (trachea), S11.035 — Open bite of vocal cord (vocal cords), S11.15 — Open bite of thyroid gland (thyroid), +132 more

Contextual Map

Every relationship of S01.159 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.

Run S01.159 with these 15 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes

Referenced by Code Also instructions

Nearest codes (40)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Common coding questions

MedCoder editorial

Can S01.159 be billed directly?

No. S01.159 (Open bite of unspecified eyelid and periocular area) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Does S01.159 require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category S01.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "S01.159 — Open bite of unspecified eyelid and periocular area." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/s01.159-open-bite-of-unspecified-eyelid-and-periocular-area

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Open bite of unspecified eyelid and periocular area

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to S01.159 in its code family, with their registry titles.

View all codes in the S01 family