2026 ICD-10-CM Diagnosis Code S11.25XAOpen bite of pharynx and cervical esophagus, initial encounter
ICD-10-CM Codes›S00–T88›S10-S19›S11
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- 7th Character A — Initial Encounter
- Not Chronic
S11.25XA is a billable ICD-10-CM diagnosis code for open bite 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 11 through 13, 154 through 156, 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 30 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Open wounds of head and neck, initial encounter.
Code Identity
Code Classification
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.
Patient EducationClinical
Animal Bites
Wild animals usually avoid people. They might attack, however, if they feel threatened, are sick, or are protecting their young or territory. Attacks by pets are more common. Animal bites rarely are life-threatening, but if they become infected, you can develop serious medical problems.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S11.25XA to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S11.25XAOverview
What is the ICD-10 code for open bite of pharynx and cervical esophagus, initial encounter?
The ICD-10-CM code for open bite of pharynx and cervical esophagus, initial encounter is S11.25XA (sometimes written as S1125XA). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is S11.25XA (Open bite of pharynx and cervical esophagus) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report open bite 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 S11.25XA mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for open bite of pharynx and cervical esophagus, such as an emergency visit or first evaluation.
What MS-DRG does S11.25XA group to?
When open bite of pharynx and cervical esophagus, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 11, 12, 13, 154, 155, 156, 963, 964, 965, with relative weights from 0.6911 to 5.4541 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S11.25XA a CC or MCC?
CMS lists S11.25XA as a CC (complication or comorbidity) for FY 2026. 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 30 closely related codes in its exclusion list.
