2027 ICD-10-CM Diagnosis Code S04.02XAInjury of optic chiasm, initial encounter

ICD-10-CM Codes›S00–T88›S00-S09›S04

ICD-10-CM S04.02XA
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

S04.02XA is a billable ICD-10-CM diagnosis code for injury of optic chiasm, initial encounter. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 91 through 93, 963 through 965. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 17 closely related codes. Coders also document this condition as injury of optic chiasm. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Injury to nerves, muscles and tendons, initial encounter.

Code Identity

ICD-10-CM Code
S04.02XA
Billable Status
Yes — Valid for Submission
Code Describes
Injury of optic chiasm, initial encounter
Short Description
Injury of optic chiasm, initial encounter
Same as the full description in the CMS dataset.
Parent Code
S04.02
Injury of optic chiasm

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionS00-S09Injuries to the head
CategoryS04Injury of cranial nerve
This CodeS04.02XAInjury of optic chiasm, initial encounter

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Injury of optic chiasm

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 2027, published by CMS and the National Center for Health Statistics.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to S04.02XA: its own notes plus those printed at S04.0, S04, block S00-S09, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From Block S00-S09 Injuries to the head applies to 1,934 codes
  • 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

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Block S00-S09 Injuries to the head applies to 1,934 codes
  • burns and corrosions (T20-T32)
  • effects of foreign body in ear (T16)
  • effects of foreign body in larynx (T17.3)
  • effects of foreign body in mouth NOS (T18.0)
  • effects of foreign body in nose (T17.0-T17.1)
  • effects of foreign body in pharynx (T17.2)
  • effects of foreign body on external eye (T15.-)
  • frostbite (T33-T34)
  • insect bite or sting, venomous (T63.4)
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes

Code First

The underlying condition named in the note is sequenced before this code.

From S04 Injury of cranial nerve applies to 114 codes
  • any associated intracranial injury (S06.-)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From S04.0 Injury of optic nerve and pathways applies to 30 codes
  • code to identify any visual field defect or blindness (H53.4-, H54.-)
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • code to identify any retained foreign body, if applicable (Z18.-)

Code Also

A second code may be needed to fully describe the condition; the note gives no sequencing direction.

From S04 Injury of cranial nerve applies to 114 codes
  • any associated:
  • open wound of head (S01.-)
  • skull fracture (S02.-)
From Block S00-S09 Injuries to the head applies to 1,934 codes
  • for any associated infection

Notes

General instructions on how these codes are used.

From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
  • The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.

7th Character

Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.

From S04 Injury of cranial nerve applies to 114 codes
  • The appropriate 7th character is to be added to each code from category S04
Values for category S04 Encounter: Initial, Subsequent, Sequela
  • Ainitial encounter this code
  • Dsubsequent encounter
  • Ssequela

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name S04.02XA, its category, or a range that includes it.

Excludes2 1

These codes carry an Excludes2 note naming S04.02XA: its condition is not part of those codes, and both may be reported when the patient has both.

  • S05 Injury of eye and orbit
    2nd cranial [optic] nerve injury (S04.0-) names S04.0-, which includes this code

Code Also 1

These codes say S04.02XA may also be needed to fully describe the condition. The note gives no sequencing direction.

  • S01 Open wound of head
    injury of cranial nerve (S04.-) names S04.-, which includes this code

Clinical ClassificationClinical

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

CCSR INJ025
Injury to nerves, muscles and tendons, initial 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 S04.02XA to ICD-9-CMHistory

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

ICD-9-CM
950.1 Injury to optic chiasm
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 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About S04.02XAOverview

What is the ICD-10 code for injury of optic chiasm, initial encounter?

The ICD-10-CM code for injury of optic chiasm, initial encounter is S04.02XA (sometimes written as S0402XA). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is S04.02XA (Injury of optic chiasm) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report injury of optic chiasm, initial encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What does the 7th character A in S04.02XA mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for injury of optic chiasm, such as an emergency visit or first evaluation.

What MS-DRG does S04.02XA group to?

When injury of optic chiasm, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 964, 965, 91, 92, 963, 93, with relative weights from 0.7783 to 2.6361 depending on complications. Higher weights mean higher Medicare reimbursement.

Is S04.02XA a CC or MCC?

CMS lists S04.02XA as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 17 closely related codes in its exclusion list.