2027 ICD-10-CM Diagnosis Code S05.21XAOcular laceration and rupture with prolapse or loss of intraocular tissue, right eye, initial encounter

ICD-10-CM Codes›S00–T88›S00-S09›S05

ICD-10-CM S05.21XA
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

S05.21XA is a billable ICD-10-CM diagnosis code for ocular laceration and rupture with prolapse or loss of intraocular tissue, right eye, 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 124 through 125, 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 57 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Open wounds of head and neck, initial encounter.

Code Identity

ICD-10-CM Code
S05.21XA
Billable Status
Yes — Valid for Submission
Code Describes
Ocular laceration and rupture with prolapse or loss of intraocular tissue, right eye, initial encounter
Short Description
Oclr lac/rupt w prolaps/loss of intraoc tissue, r eye, init
Parent Code
S05.21
Ocular laceration and rupture with prolapse or loss of intraocular tissue, right eye

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionS00-S09Injuries to the head
CategoryS05Injury of eye and orbit
This CodeS05.21XAOcular laceration and rupture with prolapse or loss of intraocular tissue, right eye, initial encounter

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Bilateral laceration of eyes co-occurrent with loss of intraocular tissue
  • Bilateral laceration of eyes co-occurrent with prolapse of intraocular tissue
  • Bilateral ocular trauma
  • Bilateral rupture of eyes co-occurrent with loss of intraocular tissue
  • Bilateral rupture of eyes co-occurrent with prolapse of intraocular tissue
  • Laceration of globe of left eye
  • Laceration of globe of right eye
  • Loss of tissue of right eye and laceration
  • Loss of tissue of right eye and rupture
  • Ocular laceration with intraocular prolapse
  • Prolapse of left eye and laceration
  • Prolapse of left eye and rupture
  • Prolapse of right eye and laceration
  • Prolapse of right eye and rupture

Coding GuidelinesGuidance

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 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 S05.21XA: its own notes plus those printed at S05, 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 S05 Injury of eye and orbit applies to 90 codes
  • open wound of eye and orbit
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 S05 Injury of eye and orbit applies to 90 codes
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

Use Additional Code

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

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 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 S05 Injury of eye and orbit applies to 90 codes
  • The appropriate 7th character is to be added to each code from category S05
Values for category S05 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 S05.21XA, its category, or a range that includes it.

Excludes1 4

These codes carry an Excludes1 note naming S05.21XA: they are not reported together with it, unless the two conditions are unrelated.

  • H43.0 Vitreous prolapse
    traumatic vitreous prolapse (S05.2-) names S05.2-, which includes this code
  • H44.6 Retained (old) intraocular foreign body, magnetic
    current intraocular foreign body (S05.-) names S05.-, which includes this code
  • H44.7 Retained (old) intraocular foreign body, nonmagnetic
    current intraocular foreign body (S05.-) names S05.-, which includes this code
  • S00 Superficial injury of head
    injury of eye and orbit (S05.-) names S05.-, which includes this code

Excludes2 2

These codes carry an Excludes2 note naming S05.21XA: its condition is not part of those codes, and both may be reported when the patient has both.

  • Chapter 7 (H00-H59) Diseases of the eye and adnexa
    injury (trauma) of eye and orbit (S05.-) names S05.-, which includes this code
  • S01 Open wound of head
    injury of eye and orbit (S05.-) names S05.-, which includes this code

Clinical ClassificationClinical

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

CCSR INJ011
Open wounds of head and neck, initial encounter
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

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.

Read the full article at MedlinePlus

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

Convert S05.21XA to ICD-9-CMHistory

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

ICD-9-CM
871.1 Ocular lacera w prolapse
Approximate The match is approximate rather than exact.
ICD-9-CM
871.2 Rupture eye w tissu loss
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 S05.21XAOverview

Is S05.21XA a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report ocular laceration and rupture with prolapse or loss of intraocular tissue, right eye, initial encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What does the 7th character A in S05.21XA mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for ocular laceration and rupture with prolapse or loss of intraocular tissue, such as an emergency visit or first evaluation.

What MS-DRG does S05.21XA group to?

When ocular laceration and rupture with prolapse or loss of intraocular tissue, right eye, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 964, 965, 125, 124, 963, with relative weights from 0.7699 to 2.6361 depending on complications. Higher weights mean higher Medicare reimbursement.

Is S05.21XA a CC or MCC?

CMS lists S05.21XA 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 57 closely related codes in its exclusion list.

What is the ICD-9 equivalent of S05.21XA?

Under the General Equivalence Mappings, ocular laceration and rupture with prolapse or loss of intraocular tissue, right eye, initial encounter converts to ICD-9-CM 871.1 (ocular lacera w prolapse) and 871.2 (rupture eye w tissu loss). The mapping is approximate, so confirm the match fits the documentation.