2026 ICD-10-CM Diagnosis Code S91.104AUnspecified open wound of right lesser toe(s) without damage to nail, initial encounter

ICD-10-CM Codes›S00–T88›S90-S99›S91

ICD-10-CM S91.104A
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

S91.104A is a billable ICD-10-CM diagnosis code for unspecified open wound of right lesser toe(s) without damage to nail, 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 604 through 605, 963 through 965. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Open wounds to limbs, initial encounter.

Code Identity

ICD-10-CM Code
S91.104A
Billable Status
Yes — Valid for Submission
Code Describes
Unspecified open wound of right lesser toe(s) without damage to nail, initial encounter
Short Description
Unsp opn wnd right lesser toe(s) w/o damage to nail, init
Parent Code
S91.104
Unspecified open wound of right lesser toe(s) without damage to nail

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionS90-S99Injuries to the ankle and foot
CategoryS91Open wound of ankle, foot and toes
This CodeS91.104AUnspecified open wound of right lesser toe(s) without damage to nail, initial encounter

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Open fracture distal phalanx, toe
  • Open fracture middle phalanx, toe
  • Open fracture of distal phalanx of lesser toe of right foot
  • Open fracture of middle phalanx of lesser toe
  • Open fracture of middle phalanx of lesser toe of right foot
  • Open fracture of phalanx of lesser toe
  • Open fracture of phalanx of lesser toe of right foot
  • Open fracture of phalanx of right foot
  • Open fracture of proximal phalanx of lesser toe of right foot
  • Open fracture proximal phalanx, toe
  • Open traumatic dislocation of interphalangeal joint of lesser toe of right foot
  • Open traumatic dislocation of joint of right foot
  • Open traumatic dislocation of joint of right toe
  • Open wound of lesser toe of right foot
  • Traumatic dislocation of interphalangeal joint of lesser toe
  • Traumatic dislocation of lesser toe

Coding GuidelinesGuidance

The appropriate 7th character is to be added to each code from block Open wound of ankle, foot and toes (S91). 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 INJ012
Open wounds to limbs, initial encounter
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Toe Injuries and Disorders

Fourteen of the 26 bones in your feet are in your toes. The toes, particularly your big toe, help you move and keep your balance. Playing sports, running, stubbing your toe, and dropping something on your foot can damage your toes. Wearing shoes that are too loose or too tight can also cause toe problems.

Read the full article at MedlinePlus

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

Convert S91.104A to ICD-9-CMHistory

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

ICD-9-CM
893.0 Open wound of toe
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 S91.104AOverview

Is S91.104A a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report unspecified open wound of right lesser toe(s) without damage to nail, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character A in S91.104A mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for unspecified open wound of right lesser toe(s) without damage to nail, such as an emergency visit or first evaluation.

What MS-DRG does S91.104A group to?

When unspecified open wound of right lesser toe(s) without damage to nail, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 604, 605, 963, 964, 965, with relative weights from 0.9160 to 2.7338 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of S91.104A?

Under the General Equivalence Mappings, unspecified open wound of right lesser toe(s) without damage to nail, initial encounter converts to ICD-9-CM 893.0 (open wound of toe). 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.