S11.25XA — Open bite of pharynx and cervical esophagus, initial encounter
Is S11.25XA billable?
Yes — S11.25XA is billable for FY2027. S11.25XA is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. S11.25XA may be submitted for encounters from October 1, 2026 through September 30, 2027.
S11.25XA at a glance
| Code | S11.25XA |
|---|---|
| Description | Open bite of pharynx and cervical esophagus, initial encounter |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "A" | initial encounter |
What does the 7th character "A" mean in S11.25XA?
In S11.25XA, the 7th character A means initial encounter. The 7th character is required for S11.25XA to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does S11.25XA group to?
S11.25XA sits in MDC Pre and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 011Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCCsurgical
- 012Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CCsurgical
- 013Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCCsurgical
As a secondary diagnosis, S11.25XA is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is S11.25XA listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S11.25, the nearest indexed parent of S11.25XA. Use them to find the family, then select the specific code.
- Bite › esophagus, cervical (s) (animal) (human)
- Bite › pharynx (s) (animal) (human)
- Wound, open › cervical esophagus › bite
Inclusion terms
Alternative wording in documentation that is classified to S11.25XA.
- Bite of pharynx and cervical esophagus NOS
Excludes1 — never code together — inherited from S11.2
The conditions below can never be reported together with S11.25XA on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- open wound of esophagus NOS (S27.8-)
Use additional code — inherited from Chapter 19
Report an additional code alongside S11.25XA to fully describe the condition. S11.25XA is sequenced first.
- code to identify any retained foreign body, if applicable (Z18.-)
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of S11.25XA, but a patient may have both at the same time. When documentation supports it, S11.25XA and the excluded code may both be reported.
Excludes2 — not included here — inherited from S10-S19
The conditions below are not part of S11.25XA, but a patient may have both at the same time. When documentation supports it, S11.25XA and the excluded code may both be reported.
Excludes2 — not included here — inherited from S11
The conditions below are not part of S11.25XA, but a patient may have both at the same time. When documentation supports it, S11.25XA and the excluded code may both be reported.
- open fracture of vertebra (S12.- with 7th character B)
Code also — inherited from S11
Two codes may be needed to describe the condition fully. Whether S11.25XA is sequenced first depends on the reason for the encounter.
How long has S11.25XA existed?
S11.25XA has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.