2026 ICD-10-CM Diagnosis Code S04.011SInjury of optic nerve, right eye, sequela
S04.011S is a billable ICD-10-CM diagnosis code for injury of optic nerve, right eye, sequela. The 7th character S marks it as a sequela code, which reports a problem that remains after the original condition has resolved. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). 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, sequela.
Code Identity
Code Classification
Present on Admission (POA)Billing
S04.011S 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.
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 S04.011S to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S04.011SOverview
Is S04.011S (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, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in S04.011S mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the injury of optic nerve itself has resolved, not the original event.
Is S04.011S 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, sequela on inpatient claims.
What is the ICD-9 equivalent of S04.011S?
Under the General Equivalence Mappings, injury of optic nerve, right eye, sequela converts to ICD-9-CM 907.1 (late eff cran nerve inj). 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.
