2026 ICD-10-CM Diagnosis Code S05.42XAPenetrating wound of orbit with or without foreign body, left eye, initial encounter

ICD-10-CM Codes›S00–T88›S00-S09›S05

ICD-10-CM S05.42XA
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

S05.42XA is a billable ICD-10-CM diagnosis code for penetrating wound of orbit with or without foreign body, left 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 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 124 through 125, 963 through 965. 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
S05.42XA
Billable Status
Yes — Valid for Submission
Code Describes
Penetrating wound of orbit with or without foreign body, left eye, initial encounter
Short Description
Penetrating wound of orbit w or w/o fb, left eye, init
Parent Code
S05.42
Penetrating wound of orbit with or without foreign body, left eye

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionS00-S09Injuries to the head
CategoryS05Injury of eye and orbit
This CodeS05.42XAPenetrating wound of orbit with or without foreign body, left eye, initial encounter

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 medial wall of orbit
  • Fracture of orbital roof
  • Open blow out fracture of orbit
  • Open blow out fracture of orbital floor
  • Open blow-out fracture of left orbital floor
  • Open fracture of lateral wall of orbit
  • Open fracture of left lateral orbital wall
  • Open fracture of left orbit
  • Open fracture of left orbital floor
  • Open fracture of left orbital roof
  • Open fracture of medial wall of left orbit
  • Open fracture of medial wall of orbit
  • Open fracture of superior wall of orbit
  • Penetrating wound of left orbit
  • Penetrating wound of orbit

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.

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 S05.42XA to ICD-9-CMHistory

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

ICD-9-CM
870.3 Penetr wnd orbit w/o FB
Approximate The match is approximate rather than exact.
ICD-9-CM
870.4 Penetrat wnd orbit w FB
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 S05.42XAOverview

Is S05.42XA 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, left eye, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character A in S05.42XA mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for penetrating wound of orbit with or without foreign body, such as an emergency visit or first evaluation.

What MS-DRG does S05.42XA group to?

When penetrating wound of orbit with or without foreign body, left eye, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 124, 125, 963, 964, 965, with relative weights from 0.7678 to 2.7338 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of S05.42XA?

Under the General Equivalence Mappings, penetrating wound of orbit with or without foreign body, left eye, initial encounter converts to ICD-9-CM 870.3 (penetr wnd orbit w/o FB) and 870.4 (penetrat wnd orbit w FB). 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.