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S91.255 ICD-10-CM Code: Open bite of left lesser toe(s) with damage to nail

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FY 2026 Apr update / Injury, poisoning and certain other consequences of external causes (S00-T88) / Injuries to the ankle and foot (S90-S99)

S91.255

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

Open bite of left lesser toe(s) with damage to nail

Open bite of left lesser toe(s) with damage to nail

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
S91.2Open wound of toe with damage to nail
S91.25Open bite of toe with damage to nail
S91.255Open bite of left lesser toe(s) with damage to nail

Inclusion Terms

Official
  • Bite of toe with damage to nail NOS

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for S91.255 in this effective period.

Related Child Codes

Official
S91.255AOpen bite of left lesser toe(s) with damage to nail, initial encounter
S91.255DOpen bite of left lesser toe(s) with damage to nail, subsequent encounter
S91.255SOpen bite of left lesser toe(s) with damage to nail, sequela

Includes

Official

ICD-10-CM does not list Includes notes for S91.255 in this effective period.

Excludes 1

Official
  • superficial bite of toe (S90.46-, S90.47-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for S91.255 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for S91.255 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for S91.255 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.

What This Code Means

S91.255 is the ICD-10-CM diagnosis code for open bite of left lesser toe(s) with damage to nail. S91.255 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 ankle and foot (s90-s99).

Header codes like S91.255 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 S91.255'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 S91.255 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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