S01.55 ICD-10-CM Code: Open bite of lip and oral cavity
Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.
Official Registry Overview & Definition
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for S01.55 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).
- open skull fracture (S02.- with 7th character B) Compare S01.55 vs S02 →
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- tooth dislocation (S03.2) Compare S01.55 vs S03.2 →
- tooth fracture (S02.5) Compare S01.55 vs S02.5 →
- injury of eye and orbit (S05.-) Compare S01.55 vs S05 →
- traumatic amputation of part of head (S08.-) Compare S01.55 vs S08 →
- burns and corrosions (T20-T32) Compare S01.55 vs T20 →
- effects of foreign body in ear (T16) Compare S01.55 vs T16 →
- effects of foreign body in larynx (T17.3) Compare S01.55 vs T17.3 →
- effects of foreign body in mouth NOS (T18.0) Compare S01.55 vs T18.0 →
- effects of foreign body in nose (T17.0-T17.1) Compare S01.55 vs T17.0 →
- effects of foreign body in pharynx (T17.2) Compare S01.55 vs T17.2 →
- effects of foreign body on external eye (T15.-) Compare S01.55 vs T15 →
- frostbite (T33-T34) Compare S01.55 vs T33 →
- insect bite or sting, venomous (T63.4) Compare S01.55 vs T63.4 →
Frequently Compared Codes
The official Excludes notes on S01.55 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
- Not billable as written — a more specific code is required: S01.551A, S01.551D, S01.551S, S01.552A, S01.552D.
- Requires a 7th character. "The appropriate 7th character is to be added to each code from category S01" Options: S01.551A, S01.551D, S01.551S, S01.552A, S01.552D, S01.552S
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.
Relationships & Classification
Official ICD-10-CM tabular notes on other codes that name S01.55 or its code family.
1 Excludes1 notes: S00 (via S01.-).
3 Code Also instructions: S04 (via S01.-), S06 (via S01.-), S09.1 (via S01.-).
Contextual Map
Every relationship of S01.55 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) (S00-T88) [Hierarchy]
Referenced by Excludes1 notes
- S00 — Superficial injury of head [Excludes1](via S01.-): “open wound of head (S01.-)” · check together
Referenced by Code Also instructions
- S04 — Injury of cranial nerve [Code Also](via S01.-): “open wound of head (S01.-)” · check together
- S06 — Intracranial injury [Code Also](via S01.-): “open wound of head (S01.-)” · check together
- S09.1 — Injury of muscle and tendon of head [Code Also](via S01.-): “any associated open wound (S01.-)” · check together
Nearest codes (40)
- S01 — Open wound of head [Sibling]
- S01.522D — Laceration with foreign body of oral cavity, subsequent encounter [Sibling]
- S01.522S — Laceration with foreign body of oral cavity, sequela [Sibling]
- S01.53 — Puncture wound of lip and oral cavity without foreign body [Sibling]
- S01.531 — Puncture wound without foreign body of lip [Sibling]
- S01.531A — Puncture wound without foreign body of lip, initial encounter [Sibling]
- S01.531D — Puncture wound without foreign body of lip, subsequent encounter [Sibling]
- S01.531S — Puncture wound without foreign body of lip, sequela [Sibling]
- and 32 more
Frequently Asked Questions (FAQ) & Clinical Guidance
Can S01.55 be billed directly?
No. S01.55 (Open bite of lip and oral cavity) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.
Does S01.55 require a 7th character?
Yes. The appropriate 7th character is to be added to each code from category S01.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to S01.55 in its code family, with their registry titles.
- S01.541S — Puncture wound with foreign body of lip, sequela
- S01.542 — Puncture wound with foreign body of oral cavity
- S01.542A — Puncture wound with foreign body of oral cavity, initial encounter
- S01.542D — Puncture wound with foreign body of oral cavity, subsequent encounter
- S01.542S — Puncture wound with foreign body of oral cavity, sequela
- S01.551 — Open bite of lip
- S01.551A — Open bite of lip, initial encounter
- S01.551D — Open bite of lip, subsequent encounter
- S01.551S — Open bite of lip, sequela
- S01.552 — Open bite of oral cavity