Skip to content

S01.552A ICD-10-CM Code: Open bite of oral cavity, initial encounter

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

FY 2026 Apr update / Injury, poisoning and certain other consequences of external causes (S00-T88) / Injuries to the head (S00-S09)

S01.552A

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Open bite of oral cavity, initial encounter

Open bite of oral cavity, initial encounter

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

Basket needed

Code Book Path

Official
S01.55Open bite of lip and oral cavity
S01.552Open bite of oral cavity
S01.552AOpen bite of oral cavity, initial encounter

Inclusion Terms

Official
  • Bite of oral cavity NOS

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for S01.552A in this effective period.

Related Child Codes

Official
S01.552DOpen bite of oral cavity, subsequent encounter
S01.552SOpen bite of oral cavity, sequela

Includes

Official

ICD-10-CM does not list Includes notes for S01.552A in this effective period.

Excludes 1

Official
  • superficial bite of oral cavity (S00.572)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for S01.552A in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for S01.552A in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for S01.552A in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is S01.552A an HCC code?

No. S01.552A is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

S01.552A is the ICD-10-CM diagnosis code for open bite of oral cavity, initial encounter. S01.552A sits in the ICD-10-CM chapter for injury, poisoning and certain other consequences of external causes (s00-t88), within the section covering injuries to the head (s00-s09).

S01.552A is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

S01.552A is a billable ICD-10-CM code that can be reported on claims but does not currently contribute to a Medicare Advantage member's RAF score under any CMS risk adjustment model (V28, V24, ESRD, or RxHCC). Coders reviewing S01.552A should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for S01.552A sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

Open S01.552A in the Interactive Encoder

See full code details, coding tips, HCC mappings, and related codes in our interactive encoder. Start your 14-day Pro trial. No credit card required.