2021 ICD-10-CM Diagnosis Code S04.0

Injury of optic nerve and pathways

    2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code
  • S04.0 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
  • The 2021 edition of ICD-10-CM S04.0 became effective on October 1, 2020.
  • This is the American ICD-10-CM version of S04.0 - other international versions of ICD-10 S04.0 may differ.
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Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
  • code to identify any visual field defect or blindness (
    ICD-10-CM Diagnosis Code H53.4

    Visual field defects

      2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code
    H53.4-
    ,
    ICD-10-CM Diagnosis Code H54
    • H54 Blindness and low vision
      • H54.0 Blindness, both eyes
        • H54.0X Blindness, both eyes, different category leve...
          • H54.0X3 Blindness right eye, category 3
            • H54.0X33 Blindness right eye category 3, blindness lef...
            • H54.0X34 Blindness right eye category 3, blindness lef...
            • H54.0X35 Blindness right eye category 3, blindness lef...
          • H54.0X4 Blindness right eye, category 4
            • H54.0X43 Blindness right eye category 4, blindness lef...
            • H54.0X44 Blindness right eye category 4, blindness lef...
            • H54.0X45 Blindness right eye category 4, blindness lef...
          • H54.0X5 Blindness right eye, category 5
            • H54.0X53 Blindness right eye category 5, blindness lef...
            • H54.0X54 Blindness right eye category 5, blindness lef...
            • H54.0X55 Blindness right eye category 5, blindness lef...
      • H54.1 Blindness, one eye, low vision other eye
        • H54.10 Blindness, one eye, low vision other eye, uns...
        • H54.11 Blindness, right eye, low vision left eye
          • H54.113 Blindness right eye category 3, low vision le...
            • H54.1131 Blindness right eye category 3, low vision le...
            • H54.1132 Blindness right eye category 3, low vision le...
          • H54.114 Blindness right eye category 4, low vision le...
            • H54.1141 Blindness right eye category 4, low vision le...
            • H54.1142 Blindness right eye category 4, low vision le...
          • H54.115 Blindness right eye category 5, low vision le...
            • H54.1151 Blindness right eye category 5, low vision le...
            • H54.1152 Blindness right eye category 5, low vision le...
        • H54.12 Blindness, left eye, low vision right eye
          • H54.121 Low vision right eye category 1, blindness le...
            • H54.1213 Low vision right eye category 1, blindness le...
            • H54.1214 Low vision right eye category 1, blindness le...
            • H54.1215 Low vision right eye category 1, blindness le...
          • H54.122 Low vision right eye category 2, blindness le...
            • H54.1223 Low vision right eye category 2, blindness le...
            • H54.1224 Low vision right eye category 2, blindness le...
            • H54.1225 Low vision right eye category 2, blindness le...
      • H54.2 Low vision, both eyes
        • H54.2X Low vision, both eyes, different category lev...
          • H54.2X1 Low vision, right eye, category 1
            • H54.2X11 Low vision right eye category 1, low vision l...
            • H54.2X12 Low vision right eye category 1, low vision l...
          • H54.2X2 Low vision, right eye, category 2
            • H54.2X21 Low vision right eye category 2, low vision l...
            • H54.2X22 Low vision right eye category 2, low vision l...
      • H54.3 Unqualified visual loss, both eyes
      • H54.4 Blindness, one eye
        • H54.40 …… unspecified eye
        • H54.41 Blindness, right eye, normal vision left eye
          • H54.413 Blindness, right eye, category 3
            • H54.413A Blindness right eye category 3, normal vision...
          • H54.414 Blindness, right eye, category 4
            • H54.414A Blindness right eye category 4, normal vision...
          • H54.415 Blindness, right eye, category 5
            • H54.415A Blindness right eye category 5, normal vision...
        • H54.42 Blindness, left eye, normal vision right eye
          • H54.42A Blindness, left eye, category 3-5
            • H54.42A3 Blindness left eye category 3, normal vision ...
            • H54.42A4 Blindness left eye category 4, normal vision ...
            • H54.42A5 Blindness left eye category 5, normal vision ...
      • H54.5 Low vision, one eye
        • H54.50 …… unspecified eye
        • H54.51 Low vision, right eye, normal vision left eye...
          • H54.511 Low vision, right eye, category 1-2
            • H54.511A Low vision right eye category 1, normal visio...
            • H54.512A Low vision right eye category 2, normal visio...
        • H54.52 Low vision, left eye, normal vision right eye...
          • H54.52A Low vision, left eye, category 1-2
            • H54.52A1 Low vision left eye category 1, normal vision...
            • H54.52A2 Low vision left eye category 2, normal vision...
      • H54.6 Unqualified visual loss, one eye
        • H54.60 Unqualified visual loss, one eye, unspecified...
        • H54.61 Unqualified visual loss, right eye, normal vi...
        • H54.62 Unqualified visual loss, left eye, normal vis...
      • H54.7 Unspecified visual loss
      • H54.8 Legal blindness, as defined in USA
    H54.-
    )
The following code(s) above S04.0 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to S04.0:
  • S00-T88
    2021 ICD-10-CM Range S00-T88

    Injury, poisoning and certain other consequences of external causes

    Note
    • Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
    Type 1 Excludes
    Use Additional
    • code to identify any retained foreign body, if applicable (Z18.-)
    Injury, poisoning and certain other consequences of external causes
  • S00-S09
    2021 ICD-10-CM Range S00-S09

    Injuries to the head

    Code Also
    • for any associated infection
    Includes
    • 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
    Type 2 Excludes
    • 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)
    Injuries to the head
  • S04
    ICD-10-CM Diagnosis Code S04

    Injury of cranial nerve

      2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code
    Applicable To
    • The selection of side should be based on the side of the body being affected
    Code First
    • any associated intracranial injury (S06.-)
    Code Also
    • any associated:
    • open wound of head (S01.-)
    • skull fracture (S02.-)
    Injury of cranial nerve
Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change
  • 2021 (effective 10/1/2020): No change
Code annotations containing back-references to S04.0:
  • Type 2 Excludes: S05
    ICD-10-CM Diagnosis Code S05

    Injury of eye and orbit

      2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code
    Includes
    • open wound of eye and orbit
    Type 2 Excludes
ICD-10-CM Codes Adjacent To S04.0
S03.43XS …… sequela
S03.8 Sprain of joints and ligaments of other parts of head
S03.8XXA …… initial encounter
S03.8XXD …… subsequent encounter
S03.8XXS …… sequela
S03.9 Sprain of joints and ligaments of unspecified parts of head
S03.9XXA …… initial encounter
S03.9XXD …… subsequent encounter
S03.9XXS …… sequela
S04 Injury of cranial nerve
S04.0 Injury of optic nerve and pathways
S04.01 Injury of optic nerve
S04.011 Injury of optic nerve, right eye
S04.011A …… initial encounter
S04.011D …… subsequent encounter
S04.011S …… sequela
S04.012 Injury of optic nerve, left eye
S04.012A …… initial encounter
S04.012D …… subsequent encounter
S04.012S …… sequela
S04.019 Injury of optic nerve, unspecified eye

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.