2025 ICD-10-CM code S05.1
(Active) Effective Date: N/A Revision Date: N/A Injury - Injuries to the eye Injury, poisoning and certain other consequences of external causes (S00-T88) Feed
Contusion of eyeball and orbital tissues.
Modifiers may be applicable depending on the circumstances of the encounter and the specific services provided. Consult the official coding guidelines for specific modifier usage.
Medical necessity for the diagnosis and treatment of contusions of the eyeball and orbital tissues is established when there is documented evidence of trauma resulting in clinically significant symptoms or potential for vision-threatening complications.This documentation would include the clinical findings such as decreased visual acuity, periorbital swelling, pain, and other objective findings.
Diagnosis and treatment of eye contusions are the responsibility of ophthalmologists or other qualified healthcare providers trained in ophthalmology. This includes taking a patient history, performing a thorough physical examination, ordering and interpreting imaging studies (like X-rays and MRIs), and managing treatment (such as pain relief, inflammation reduction, and infection prevention).
- Injury, poisoning and certain other consequences of external causes (S00-T88)
- Injuries to the head (S00-S09)
In simple words: A bruise of the eye and the area around it (the eye socket) is caused by a blunt injury that breaks tiny blood vessels under the skin.This causes a black eye and may be accompanied by swelling, pain, and tenderness. Doctors diagnose it with a physical exam and sometimes imaging tests. Treatment can include ice, rest, pain relievers, and antibiotics.
A contusion, also known as a bruise or ecchymosis, of the eyeball and orbital tissues refers to discoloration caused by blunt trauma that ruptures small blood vessels beneath the skin, resulting in subcutaneous blood accumulation.Symptoms may include redness, swelling, tenderness, pain, and discoloration. Diagnosis involves patient history, physical examination (assessing tenderness, swelling, visual acuity, and eye movement), and imaging (X-rays, MRI). Treatment might include saline irrigation, ice application, sunglasses, rest, analgesics, antibiotics, and anti-inflammatory eye drops.
Example 1: A patient presents after a fistfight with periorbital ecchymosis and tenderness, visual acuity is slightly diminished.Diagnosis: Contusion of eyeball and orbital tissues, right eye (S05.11). Treatment: Ice packs, analgesics, close observation for visual acuity changes., A child falls and hits their face on the pavement. They have significant swelling and pain around their left eye and are unable to see clearly out of it. Diagnosis: Contusion of eyeball and orbital tissues, left eye (S05.12). Treatment includes ice packs, ophthalmologic consultation to assess for potential retinal detachment., An elderly patient is involved in a car accident. They sustain a blunt force trauma to the face.They present with significant swelling and pain around both eyes, limited vision in both eyes, and possible fracture. Diagnosis:Bilateral contusion of eyeball and orbital tissues (S05.1). Treatment includes immediate ophthalmological consultation, imaging (CT scan), pain management, and possible surgical intervention.
Detailed patient history including mechanism of injury, assessment of visual acuity, ophthalmologic examination findings, imaging reports (if performed), and treatment provided. Documentation should specify the laterality (right, left, or unspecified) of the injury, and should describe the extent of the injury and any associated complications.
** This code should be used for contusions of the eyeball and orbital tissues. If the contusion involves only the eyelid and periocular area, use code S00.1 instead.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Specialties:Ophthalmology, Emergency Medicine
- Place of Service:Emergency Room - Hospital, Office, Urgent Care Facility