S25.429A — Major laceration of unspecified pulmonary blood vessels, initial encounter
Is S25.429A billable?
Yes, but S25.429A will trip a Medicare edit. S25.429A is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S25.429A under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.
S25.429A at a glance
| Code | S25.429A |
|---|---|
| Description | Major laceration of unspecified pulmonary blood vessels, 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 S25.429A?
In S25.429A, the 7th character A means initial encounter. The 7th character is required for S25.429A to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to S25.429A?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S25.429A directly.
A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.
Which MS-DRGs does S25.429A group to?
S25.429A sits in MDC 15 and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 791Prematurity with Major Problemsmedical
As a secondary diagnosis, S25.429A is a major complication or comorbidity (MCC), which can move a stay into a higher-paying DRG.
How is S25.429A listed in the Alphabetic Index?
The Alphabetic Index lists these routes under S25.42, the nearest indexed parent of S25.429A. Use them to find the family, then select the specific code.
- Injury › blood vessel NEC › thoracic › pulmonary › laceration › major
Use additional code — inherited from Chapter 19
Report an additional code alongside S25.429A to fully describe the condition. S25.429A 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 S25.429A, but a patient may have both at the same time. When documentation supports it, S25.429A and the excluded code may both be reported.
Excludes2 — not included here — inherited from S20-S29
The conditions below are not part of S25.429A, but a patient may have both at the same time. When documentation supports it, S25.429A and the excluded code may both be reported.
- burns and corrosions (T20-T32)
- effects of foreign body in bronchus (T17.5)
- effects of foreign body in esophagus (T18.1)
- effects of foreign body in lung (T17.8)
- effects of foreign body in trachea (T17.4)
- frostbite (T33-T34)
- injuries of axilla
- injuries of clavicle
- injuries of scapular region
- injuries of shoulder
- insect bite or sting, venomous (T63.4)
Code also — inherited from S25
Two codes may be needed to describe the condition fully. Whether S25.429A is sequenced first depends on the reason for the encounter.
- any associated open wound (S21.-)
How long has S25.429A existed?
S25.429A 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.