Version 2024

2024 ICD-10-CM Diagnosis Code S05.70XA

Avulsion of unspecified eye, initial encounter

ICD-10-CM Code:: S05.70XA
ICD-10 Code for:: Avulsion of unspecified eye, initial encounter
Is Billable?: Yes - Valid for Submission
Chronic Condition Indicator: ^[1]: Not chronic
Code Navigator:

Code Information
Approximate Synonyms
Clinical Classification
Coding Guidelines
Tabular List of Diseases and Injuries
Code Edits
Diagnostic Related Groups Mapping
Convert to ICD-9 Code
Patient Education
Other Codes Used Similar Conditions
Code History

Code Classification

Injury, poisoning and certain other consequences of external causes
(S00–T88)
- Injuries to the head
  (S00-S09)
  - Injury of eye and orbit
    (S05)

S05.70XA is a billable diagnosis code used to specify a medical diagnosis of avulsion of unspecified eye, initial encounter. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

S05.70XA is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like avulsion of unspecified eye. According to ICD-10-CM Guidelines an "initial encounter" doesn't necessarily means "initial visit". The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.

Unspecified diagnosis codes like S05.70XA are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

Avulsion of eye
Avulsion of nerve of eyelid
Avulsion of periorbital region
Traumatic enucleation of eye

Clinical Classification

Clinical Category is Open wounds of head and neck, initial encounter
CCSR Category Code: INJ011
Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Coding Guidelines

The appropriate 7th character is to be added to each code from block Injury of eye and orbit (S05). Use the following options for the aplicable episode of care:

A - initial encounter
D - subsequent encounter
S - sequela

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

Unspecified codes - Unspecified codes exist in the ICD-10-CM classification for circumstances when documentation in the medical record does not provide the level of detail needed to support reporting a more specific code. However, in the inpatient setting, there should generally be very limited and rare circumstances for which the laterality (right, left, bilateral) of a condition is unable to be documented and reported. The following pages contain the list of unspecified ICD-10-CM diagnosis codes for which there is a more specific code to identify laterality (right, left, bilateral) within that code family.

S05.70XA is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
124	OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT	02	1.3219
125	OTHER DISORDERS OF THE EYE WITHOUT MCC	02	0.7975

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Convert S05.70XA to ICD-9-CM

ICD-9-CM Code: 871.3 - Avulsion of eye
Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education

Eye Injuries

The structure of your face helps protect your eyes from injury. Still, injuries can damage your eye, sometimes severely enough that you could lose your vision. Most eye injuries are preventable. If you play sports or work in certain jobs, you may need protection.

The most common type of injury happens when something irritates the outer surface of your eye. Certain jobs such as industrial jobs or hobbies such as carpentry make this type of injury more likely. It's also more likely if you wear contact lenses.

Chemicals or heat can burn your eyes. With chemicals, the pain may cause you to close your eyes. This traps the irritant next to the eye and may cause more damage. You should wash out your eye right away while you wait for medical help.

[Learn More in MedlinePlus]

Other ICD-10-CM Codes Commonly Used for Similar Conditions

Filter related codes list:

S05 Injury of eye and orbit.
S05.0 Injury of conjunctiva and corneal abrasion without foreign body.
S05.00 Injury of conjunctiva and corneal abrasion without foreign body, unspecified eye.
S05.00XA Injury of conjunctiva and corneal abrasion without foreign body, unspecified eye, initial encounter.
S05.00XD Injury of conjunctiva and corneal abrasion without foreign body, unspecified eye, subsequent encounter.
S05.00XS Injury of conjunctiva and corneal abrasion without foreign body, unspecified eye, sequela.
S05.01 Injury of conjunctiva and corneal abrasion without foreign body, right eye.
S05.01XA Injury of conjunctiva and corneal abrasion without foreign body, right eye, initial encounter.
S05.01XD Injury of conjunctiva and corneal abrasion without foreign body, right eye, subsequent encounter.
S05.01XS Injury of conjunctiva and corneal abrasion without foreign body, right eye, sequela.
S05.02 Injury of conjunctiva and corneal abrasion without foreign body, left eye.
S05.02XA Injury of conjunctiva and corneal abrasion without foreign body, left eye, initial encounter.
S05.02XD Injury of conjunctiva and corneal abrasion without foreign body, left eye, subsequent encounter.
S05.02XS Injury of conjunctiva and corneal abrasion without foreign body, left eye, sequela.
S05.1 Contusion of eyeball and orbital tissues.
S05.10 Contusion of eyeball and orbital tissues, unspecified eye.
S05.10XA Contusion of eyeball and orbital tissues, unspecified eye, initial encounter.
S05.10XD Contusion of eyeball and orbital tissues, unspecified eye, subsequent encounter.
S05.10XS Contusion of eyeball and orbital tissues, unspecified eye, sequela.
S05.11 Contusion of eyeball and orbital tissues, right eye.
S05.11XA Contusion of eyeball and orbital tissues, right eye, initial encounter.
S05.11XD Contusion of eyeball and orbital tissues, right eye, subsequent encounter.
S05.11XS Contusion of eyeball and orbital tissues, right eye, sequela.
S05.12 Contusion of eyeball and orbital tissues, left eye.
S05.12XA Contusion of eyeball and orbital tissues, left eye, initial encounter.
S05.12XD Contusion of eyeball and orbital tissues, left eye, subsequent encounter.
S05.12XS Contusion of eyeball and orbital tissues, left eye, sequela.
S05.2 Ocular laceration and rupture with prolapse or loss of intraocular tissue.
S05.20 Ocular laceration and rupture with prolapse or loss of intraocular tissue, unspecified eye.
S05.20XA Ocular laceration and rupture with prolapse or loss of intraocular tissue, unspecified eye, initial encounter.
S05.20XD Ocular laceration and rupture with prolapse or loss of intraocular tissue, unspecified eye, subsequent encounter.
S05.20XS Ocular laceration and rupture with prolapse or loss of intraocular tissue, unspecified eye, sequela.
S05.21 Ocular laceration and rupture with prolapse or loss of intraocular tissue, right eye.
S05.21XA Ocular laceration and rupture with prolapse or loss of intraocular tissue, right eye, initial encounter.
S05.21XD Ocular laceration and rupture with prolapse or loss of intraocular tissue, right eye, subsequent encounter.
S05.21XS Ocular laceration and rupture with prolapse or loss of intraocular tissue, right eye, sequela.
S05.22 Ocular laceration and rupture with prolapse or loss of intraocular tissue, left eye.
S05.22XA Ocular laceration and rupture with prolapse or loss of intraocular tissue, left eye, initial encounter.
S05.22XD Ocular laceration and rupture with prolapse or loss of intraocular tissue, left eye, subsequent encounter.
S05.22XS Ocular laceration and rupture with prolapse or loss of intraocular tissue, left eye, sequela.
S05.3 Ocular laceration without prolapse or loss of intraocular tissue.
S05.30 Ocular laceration without prolapse or loss of intraocular tissue, unspecified eye.
S05.30XA Ocular laceration without prolapse or loss of intraocular tissue, unspecified eye, initial encounter.
S05.30XD Ocular laceration without prolapse or loss of intraocular tissue, unspecified eye, subsequent encounter.
S05.30XS Ocular laceration without prolapse or loss of intraocular tissue, unspecified eye, sequela.
S05.31 Ocular laceration without prolapse or loss of intraocular tissue, right eye.
S05.31XA Ocular laceration without prolapse or loss of intraocular tissue, right eye, initial encounter.
S05.31XD Ocular laceration without prolapse or loss of intraocular tissue, right eye, subsequent encounter.
S05.31XS Ocular laceration without prolapse or loss of intraocular tissue, right eye, sequela.
S05.32 Ocular laceration without prolapse or loss of intraocular tissue, left eye.
S05.32XA Ocular laceration without prolapse or loss of intraocular tissue, left eye, initial encounter.

Code History

FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.