ICDcodes.org
FY2027

S25.90XAUnspecified injury of unspecified blood vessel of thorax, initial encounter

BillableUnspecifiedCC

Is S25.90XA billable?

Yes, but S25.90XA will trip a Medicare edit. S25.90XA is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists S25.90XA 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.

S25.90XA at a glance

CodeS25.90XA
DescriptionUnspecified injury of unspecified blood vessel of thorax, initial encounter
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027
7th character "A"initial encounter

What does the 7th character "A" mean in S25.90XA?

In S25.90XA, the 7th character A means initial encounter. The 7th character is required for S25.90XA to be a valid, complete code.

Same condition, different episode of care — switch the 7th character:

What Medicare edits apply to S25.90XA?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name S25.90XA directly.

Unspecified — a laterality-specific code exists — MCE edit 20

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 S25.90XA group to?

S25.90XA sits in MDC 21 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

  • 913Traumatic Injury with MCCmedical
  • 914Traumatic Injury without MCCmedical

As a secondary diagnosis, S25.90XA is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.

How is S25.90XA listed in the Alphabetic Index?

The Alphabetic Index lists these routes under S25.90, the nearest indexed parent of S25.90XA. Use them to find the family, then select the specific code.

  • Injuryblood vessel NECthoracic

Use additional code — inherited from Chapter 19

Report an additional code alongside S25.90XA to fully describe the condition. S25.90XA 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 S25.90XA, but a patient may have both at the same time. When documentation supports it, S25.90XA and the excluded code may both be reported.

  • birth trauma (P10-P15)
  • obstetric trauma (O70-O71)

Excludes2 — not included here — inherited from S20-S29

The conditions below are not part of S25.90XA, but a patient may have both at the same time. When documentation supports it, S25.90XA 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 S25.90XA is sequenced first depends on the reason for the encounter.

  • any associated open wound (S21.-)

How long has S25.90XA existed?

S25.90XA 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.