2026 ICD-10-CM Diagnosis Code S04.011DInjury of optic nerve, right eye, subsequent encounter

ICD-10-CM Codes›S00–T88›S00-S09›S04

ICD-10-CM S04.011D
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

S04.011D is a billable ICD-10-CM diagnosis code for injury of optic nerve, right eye, subsequent encounter. The 7th character D marks it as a subsequent encounter code, used during routine care in the healing or recovery phase. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 949 through 950. The code is exempt from POA reporting. Coders also document this condition as bilateral injury of optic nerve. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Injury to nerves, muscles and tendons, subsequent encounter.

Code Identity

ICD-10-CM Code
S04.011D
Billable Status
Yes — Valid for Submission
Code Describes
Injury of optic nerve, right eye, subsequent encounter
Short Description
Injury of optic nerve, right eye, subsequent encounter
Same as the full description in the CMS dataset.
Parent Code
S04.011
Injury of optic nerve, right eye

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionS00-S09Injuries to the head
CategoryS04Injury of cranial nerve
This CodeS04.011DInjury of optic nerve, right eye, subsequent encounter

Present on Admission (POA)Billing

S04.011D is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Bilateral injury of optic nerve
  • Injury of both visual cortices
  • Injury of left visual cortex
  • Injury of right visual cortex
  • Traumatic injury of right optic nerve
  • Traumatic injury of right visual pathway
  • Traumatic optic nerve injury

Coding GuidelinesGuidance

The appropriate 7th character is to be added to each code from block Injury of cranial nerve (S04). Use the following options for the applicable episode of care:

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

Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2026, published by CMS and the National Center for Health Statistics.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INJ062
Injury to nerves, muscles and tendons, subsequent encounter
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Optic Nerve Disorders

The optic nerve is a bundle of more than 1 million nerve fibers that carry visual messages. You have one connecting the back of each eye (your retina) to your brain. Damage to an optic nerve can cause vision loss. The type of vision loss and how severe it is depends on where the damage occurs. It may affect one or both eyes.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert S04.011D to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
V58.89 Other specfied aftercare
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About S04.011DOverview

Is S04.011D (Injury of optic nerve, right eye) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report injury of optic nerve, right eye, subsequent encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character D in S04.011D mean?

The final character D marks a subsequent encounter: use it for routine care while the injury of optic nerve is healing, after active treatment has ended.

What MS-DRG does S04.011D group to?

When injury of optic nerve, right eye, subsequent encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 949, 950, with relative weights from 0.6277 to 1.1897 depending on complications. Higher weights mean higher Medicare reimbursement.

Is S04.011D exempt from POA reporting?

Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for injury of optic nerve, right eye, subsequent encounter on inpatient claims.

What is the ICD-9 equivalent of S04.011D?

Under the General Equivalence Mappings, injury of optic nerve, right eye, subsequent encounter converts to ICD-9-CM V58.89 (other specfied aftercare). The mapping is approximate, so confirm the match fits the documentation.

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.