2026 ICD-10-CM Diagnosis Code S05.40XSPenetrating wound of orbit with or without foreign body, unspecified eye, sequela
S05.40XS is a billable ICD-10-CM diagnosis code for penetrating wound of orbit with or without foreign body, unspecified 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) and groups to MS-DRG 604 through 605. The code is exempt from POA reporting. Coders also document this condition as blow out fracture of orbit. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Injury, sequela.
Code Identity
Code Classification
Present on Admission (POA)Billing
S05.40XS 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.
- Blow out fracture of orbit
- Fracture of lateral wall of orbit
- Fracture of orbital roof
- Open blow out fracture of orbit
- Open fracture of lateral wall of orbit
- Open fracture of superior wall of orbit
- Orbital foreign body
- Penetrating wound of orbit
- Penetrating wound of orbit with foreign body
- Penetrating wound of orbit without foreign body
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 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
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
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Convert S05.40XS to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S05.40XSOverview
Is S05.40XS a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report penetrating wound of orbit with or without foreign body, unspecified eye, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in S05.40XS mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the penetrating wound of orbit with or without foreign body itself has resolved, not the original event.
What MS-DRG does S05.40XS group to?
When penetrating wound of orbit with or without foreign body, unspecified eye, sequela is the principal diagnosis on an inpatient stay, it groups to MS-DRG 604, 605, with relative weights from 0.9160 to 1.4721 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S05.40XS 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 penetrating wound of orbit with or without foreign body, unspecified eye, sequela on inpatient claims.
What is the ICD-9 equivalent of S05.40XS?
Under the General Equivalence Mappings, penetrating wound of orbit with or without foreign body, unspecified eye, sequela converts to ICD-9-CM 906.0 (lt eff opn wnd head/trnk). 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.
