2026 ICD-10-CM Diagnosis Code S11.20XAUnspecified open wound of pharynx and cervical esophagus, initial encounter

ICD-10-CM Codes›S00–T88›S10-S19›S11

ICD-10-CM S11.20XA
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

S11.20XA is a billable ICD-10-CM diagnosis code for unspecified open wound of pharynx and cervical esophagus, 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 154 through 156, 963 through 965. Coders also document this condition as open wound of pharynx. 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
S11.20XA
Billable Status
Yes — Valid for Submission
Code Describes
Unspecified open wound of pharynx and cervical esophagus, initial encounter
Short Description
Unsp open wound of pharynx and cervical esophagus, init
Parent Code
S11.20
Unspecified open wound of pharynx and cervical esophagus

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionS10-S19Injuries to the neck
CategoryS11Open wound of neck
This CodeS11.20XAUnspecified open wound of pharynx and cervical esophagus, initial encounter

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Open wound of pharynx
  • Wound of oropharynx

Coding GuidelinesGuidance

The appropriate 7th character is to be added to each code from block Open wound of neck (S11). 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

Esophagus Disorders

The esophagus is the muscular tube that carries food and liquids from your mouth to the stomach. You may not be aware of your esophagus until you swallow something too large, too hot, or too cold. You may also notice it when something is wrong. You may feel pain or have trouble swallowing.

Read the full article at MedlinePlus

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

Convert S11.20XA to ICD-9-CMHistory

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

ICD-9-CM
874.4 Open wound of pharynx
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 S11.20XAOverview

Is S11.20XA (Unspecified open wound of pharynx and cervical esophagus) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report unspecified open wound of pharynx and cervical esophagus, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character A in S11.20XA mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for unspecified open wound of pharynx and cervical esophagus, such as an emergency visit or first evaluation.

What MS-DRG does S11.20XA group to?

When unspecified open wound of pharynx and cervical esophagus, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 154, 155, 156, 963, 964, 965, with relative weights from 0.6911 to 2.7338 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of S11.20XA?

Under the General Equivalence Mappings, unspecified open wound of pharynx and cervical esophagus, initial encounter converts to ICD-9-CM 874.4 (open wound of pharynx). 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.