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S31.659D ICD-10-CM Code: Open bite of abdominal wall, unspecified quadrant with penetration into peritoneal cavity, subsequent encounter

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FY 2026 Apr update / Injury, poisoning and certain other consequences of external causes (S00-T88) / Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals (S30-S39)

S31.659D

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

Open bite of abdominal wall, unspecified quadrant with penetration into peritoneal cavity, subsequent encounter

Open bite of abdominal wall, unspecified quadrant with penetration into peritoneal cavity, subsequent 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

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Code Book Path

Official
S31.65Open bite of abdominal wall with penetration into peritoneal cavity
S31.659Open bite of abdominal wall, unspecified quadrant with penetration into peritoneal cavity
S31.659DOpen bite of abdominal wall, unspecified quadrant with penetration into peritoneal cavity, subsequent encounter

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for S31.659D in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for S31.659D in this effective period.

Related Child Codes

Official
S31.659AOpen bite of abdominal wall, unspecified quadrant with penetration into peritoneal cavity, initial encounter
S31.659SOpen bite of abdominal wall, unspecified quadrant with penetration into peritoneal cavity, sequela

Includes

Official

ICD-10-CM does not list Includes notes for S31.659D in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for S31.659D in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for S31.659D in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for S31.659D in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for S31.659D 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 S31.659D an HCC code?

No. S31.659D 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

S31.659D is the ICD-10-CM diagnosis code for open bite of abdominal wall, unspecified quadrant with penetration into peritoneal cavity, subsequent encounter. S31.659D 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 abdomen, lower back, lumbar spine, pelvis and external genitals (s30-s39).

S31.659D 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.

S31.659D 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 S31.659D 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 S31.659D sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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