2025 ICD-10-CM Diagnosis Code S05.11XS
Contusion of eyeball and orbital tissues, right eye, sequela
- ICD-10-CM Code:
- S05.11XS
- ICD-10 Code for:
- Contusion of eyeball and orbital tissues, right eye, sequela
- Is Billable?
- Yes - Valid for Submission
- Chronic Condition Indicator: [1]
- Not chronic
- Code Navigator:
S05.11XS is a billable diagnosis code used to specify a medical diagnosis of contusion of eyeball and orbital tissues, right eye, sequela. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2024 through September 30, 2025. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
S05.11XS is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like contusion of eyeball and orbital tissues right eye. According to ICD-10-CM Guidelines a "sequela" code should be used for chronic or residual conditions that are complications of an initial acute disease, illness or injury. The most common sequela is pain. Usually, two diagnosis codes are needed when reporting sequela. The first code describes the nature of the sequela while the second code describes the sequela or late effect.
Approximate Synonyms
The following list of clinical terms are approximate synonyms, alternative descriptions, or common phrases that might be used by patients, healthcare providers, or medical coders to describe the same condition. These synonyms and related diagnosis terms are often used when searching for an ICD-10 code, especially when the exact medical terminology is unclear. Whether you're looking for lay terms, similar diagnosis names, or common language alternatives, this list can help guide you to the correct ICD-10 classification.
- Closed injury of eyeball
- Contusion of globe of eye
- Contusion of globe of right eye
- Contusion of orbital tissue of right eye
- Contusion of orbital tissues
- Contusion of right eye region
- Hyphema of right eye
- Traumatic hyphema
- Traumatic hyphema of right eye
Clinical Classification
Clinical Classifications group individual ICD-10-CM diagnosis codes into broader, clinically meaningful categories. These categories help simplify complex data by organizing related conditions under common clinical themes.
They are especially useful for data analysis, reporting, and clinical decision-making. Even when diagnosis codes differ, similar conditions can be grouped together based on their clinical relevance. Each category is assigned a unique CCSR code that represents a specific clinical concept, often tied to a body system or medical specialty.
Injury, sequela
CCSR Code: INJ073
Inpatient Default: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
Outpatient Default: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Coding Guidelines
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 aplicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Present on Admission (POA)
S05.11XS is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.
CMS POA Indicator Options and Definitions
POA Indicator: Y
Reason: Diagnosis was present at time of inpatient admission.
CMS Pays CC/MCC DRG? YES
POA Indicator: N
Reason: Diagnosis was not present at time of inpatient admission.
CMS Pays CC/MCC DRG? NO
POA Indicator: U
Reason: Documentation insufficient to determine if the condition was present at the time of inpatient admission.
CMS Pays CC/MCC DRG? NO
POA Indicator: W
Reason: Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.
CMS Pays CC/MCC DRG? YES
POA Indicator: 1
Reason: Unreported/Not used - Exempt from POA reporting.
CMS Pays CC/MCC DRG? NO
Convert S05.11XS to ICD-9-CM
Below are the ICD-9 codes that most closely match this ICD-10 code, based on the General Equivalence Mappings (GEMs). This ICD-10 to ICD-9 crosswalk tool is helpful for coders who need to reference legacy diagnosis codes for audits, historical claims, or approximate code comparisons.
Late effect of contusion
ICD-9-CM: 906.3
Approximate Flag - The approximate mapping means this ICD-10 code does not have an exact ICD-9 equivalent. The matched code is the closest available option, but it may not fully capture the original diagnosis or clinical intent.
Patient Education
Bruises
A bruise is a mark on your skin caused by blood trapped under the surface. It happens when an injury crushes small blood vessels but does not break the skin. Those vessels break open and leak blood under the skin.
Bruises are often painful and swollen. You can get skin, muscle and bone bruises. Bone bruises are the most serious.
It can take months for a bruise to fade, but most last about two weeks. They start off a reddish color, and then turn bluish-purple and greenish-yellow before returning to normal. To reduce bruising, ice the injured area and elevate it above your heart. See your health care provider if you seem to bruise for no reason, or if the bruise appears to be infected.
[Learn More in MedlinePlus]
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.
The most common type of injury happens when something irritates the outer surface of your eye. Certain jobs such as industrial jobs or hobbies such as carpentry make this type of injury more likely. It's also more likely if you wear contact lenses.
Chemicals or heat can burn your eyes. With chemicals, the pain may cause you to close your eyes. This traps the irritant next to the eye and may cause more damage. You should wash out your eye right away while you wait for medical help.
[Learn More in MedlinePlus]
Code History
- FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
- FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
- FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.
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.