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S05 ICD-10-CM Code: Injury of eye and orbit

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

S05

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Injury of eye and orbit

Injury of eye and orbit

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

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Code Book Path

Official
S0Injuries to the head (S00-S09)
S05Injury of eye and orbit

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for S05 in this effective period.

Excludes 2

Official
  • 2nd cranial [optic] nerve injury (S04.0-)
  • 3rd cranial [oculomotor] nerve injury (S04.1-)
  • open wound of eyelid and periocular area (S01.1-)
  • orbital bone fracture (S02.1-, S02.3-, S02.8-)
  • superficial injury of eyelid (S00.1-S00.2)

Related Child Codes

Official
S05.0Injury of conjunctiva and corneal abrasion without foreign body
S05.1Contusion of eyeball and orbital tissues
S05.2Ocular laceration and rupture with prolapse or loss of intraocular tissue
S05.3Ocular laceration without prolapse or loss of intraocular tissue
S05.4Penetrating wound of orbit with or without foreign body

Includes

Official
  • open wound of eye and orbit

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for S05 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for S05 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for S05 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for S05 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.

Coder workflow notes

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What This Code Means

S05 is the ICD-10-CM diagnosis code for injury of eye and orbit. S05 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).

Header codes like S05 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at S05's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for S05 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Includes

  • open wound of eye and orbit

Excludes 2, Not included here, may code separately

  • 2nd cranial [optic] nerve injury (S04.0-)
  • 3rd cranial [oculomotor] nerve injury (S04.1-)
  • open wound of eyelid and periocular area (S01.1-)
  • orbital bone fracture (S02.1-, S02.3-, S02.8-)
  • superficial injury of eyelid (S00.1-S00.2)

Child Codes

Code Hierarchy

S05Injury of eye and orbit
S05Injury of eye and orbit

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