Is ICD-10-CM code S04 billable?

No, S04 (Injury of cranial nerve) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code S04 belong to?

S04 belongs to Chapter 19 of the ICD-10-CM tabular list: S00–T88 (Injury, Poisoning and Certain Other Consequences of External Causes).

S04Not billable, use a more specific code below

Injury of cranial nerve

In Injuries to the head (S00-S09), chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes

114 billable codes under S04: 38 are a CC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.

Instructional notes

Includes: conditions that are coded here

The selection of side should be based on the side of the body being affected

Code first: code the underlying condition first, then this code

any associated intracranial injury (S06.-)

Code also: add a code for this too, order depends on the encounter

any associated:
open wound of head (S01.-)
skull fracture (S02.-)

Also applies, from Injuries to the head (S00-S09)

These notes sit on S00-S09 and apply to every code under it, including S04.

Includes: conditions that are coded here

injuries of ear
injuries of eye
injuries of face [any part]
injuries of gum
injuries of jaw
injuries of oral cavity
injuries of palate
injuries of periocular area
injuries of scalp
injuries of temporomandibular joint area
injuries of tongue
injuries of tooth

Excludes2: not included here, code separately if applicable

burns and corrosions (T20-T32)
effects of foreign body in ear (T16)
effects of foreign body in larynx (T17.3)
effects of foreign body in mouth NOS (T18.0)
effects of foreign body in nose (T17.0-T17.1)
effects of foreign body in pharynx (T17.2)
effects of foreign body on external eye (T15.-)
frostbite (T33-T34)
insect bite or sting, venomous (T63.4)

Code also: add a code for this too, order depends on the encounter

for any associated infection

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Covers 7th character use and coding of injuries, fractures, burns, drug and toxic effects, abuse and neglect, and complications of care (S00-T88).

Application of 7th Characters in Chapter 19 (page 77)
Coding of Injuries (page 78)
Coding of Traumatic Fractures (page 79)
Coding of Burns and Corrosions (page 80)
Adverse Effects, Poisoning, Underdosing and Toxic Effects (page 82)
Adult and child abuse, neglect and other maltreatment (page 85)
Complications of care (page 85)

Read Section I.C.19 (page 77)

All codes under S04

S04 can't be used on a claim. Pick a billable code below; grey headings group them.

S04 MS-DRGs

As the principal diagnosis, the billable codes under S04 group to these 15 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 091 Other Disorders of Nervous System with MCC (45 of 114 codes)
DRG 092 Other Disorders of Nervous System with CC (45 of 114 codes)
DRG 093 Other Disorders of Nervous System without CC/MCC (45 of 114 codes)
DRG 949 Aftercare with CC/MCC (38 of 114 codes)
DRG 950 Aftercare without CC/MCC (38 of 114 codes)
DRG 963 Other Multiple Significant Trauma with MCC (38 of 114 codes)
DRG 964 Other Multiple Significant Trauma with CC (38 of 114 codes)
DRG 965 Other Multiple Significant Trauma without CC/MCC (38 of 114 codes)
DRG 073 Cranial and Peripheral Nerve Disorders with MCC (25 of 114 codes)
DRG 074 Cranial and Peripheral Nerve Disorders without MCC (25 of 114 codes)
DRG 124 Other Disorders of the Eye with MCC or Thrombolytic Agent (3 of 114 codes)
DRG 125 Other Disorders of the Eye without MCC (3 of 114 codes)
DRG 154 Other Ear, Nose, Mouth and Throat Diagnoses with MCC (3 of 114 codes)
DRG 155 Other Ear, Nose, Mouth and Throat Diagnoses with CC (3 of 114 codes)
DRG 156 Other Ear, Nose, Mouth and Throat Diagnoses without CC/MCC (3 of 114 codes)

Other codes that refer to S04

Notes on these codes point to S04.

S01 Code Also: injury of cranial nerve (S04.-)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Peripheral Nerve Disorders

Nerves are like wires that carry messages back and forth between your brain and your body. Your peripheral nerves branch off from your brain and spinal cord and connect to all parts of your body, including your muscles and organs. Peripheral nerves carry messages from your brain that control your movement, breathing, heartbeat, digestion, and more. They also carry messages from your body to your brain, so you can feel things, such as pain, heat, and cold.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.