ICD-10 S21.95
Non-Billable HeaderOpen bite of unspecified part of thorax
About ICD-10-CM S21.95
ICD-10-CM code S21.95 represents Open bite of unspecified part of thorax. This is a non-billable header code in the Injury, Poisoning, and External Causes chapter (block S21). The 2026 edition of ICD-10-CM S21.95 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Coding Tips for S21.95
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
Injury codes require a 7th character: A (initial encounter, active treatment), D (subsequent, healing/recovery), S (sequela, late effect of original injury). Codes with fewer than 6 characters need the placeholder X to bring them to 6 characters before adding the 7th. Wrong or missing 7th character is the #1 cause of injury claim denials.
Type 1 Excludes
Pure excludes, these codes can never be coded together with S21.95. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- superficial bite of thorax (S20.97)
Medicare LCD Coverage for S21.95
Local Coverage Determinations (LCDs) from CMS MACs that list S21.95 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing S21.95.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but S21.95 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with S21.95
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To S21.95
Other codes in section S20-S29 (Injuries to the thorax).
ICD-10 S21.95, Billing FAQ
Is ICD-10 code S21.95 billable? +
No, S21.95 is a non-billable header code. Use a more specific child code from block S21 when submitting claims.
What codes are Type 1 Excludes for S21.95? +
Type 1 Excludes (never code together with S21.95): superficial bite of thorax (S20.97)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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