ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 S31

Non-Billable Header

Open wound of abdomen, lower back, pelvis and external genitals

S31
Block
0
Synonyms
0
LCDs
3
Payer Policies
0
Linked CPTs

About ICD-10-CM S31

ICD-10-CM code S31 represents Open wound of abdomen, lower back, pelvis and external genitals. This is a non-billable header code in the Injury, Poisoning, and External Causes chapter (block S31). The 2026 edition of ICD-10-CM S31 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 S31

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Injury chapter (S00-T88): 7th character extension required

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 S31. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • traumatic amputation of part of abdomen, lower back and pelvis (S38.2-, S38.3)

Type 2 Excludes

Not included here, the excluded code is not part of S31, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.

  • open wound of hip (S71.00-S71.02)
  • open fracture of pelvis (S32.1--S32.9 with 7th character B)

Coding Notes

Code Also

  • any associated:
  • spinal cord injury (S24.0, S24.1-, S34.0-, S34.1-)
  • wound infection

Seven Chr Note

  • The appropriate 7th character is to be added to each code from category S31

Medicare LCD Coverage for S31

Local Coverage Determinations (LCDs) from CMS MACs that list S31 as a covered diagnosis.

No Medicare LCDs reference S31 as covered

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 S31.

3 policies

3 Cigna

Cognitive Rehabilitation - (CPG270)
Policy ID: CPG270_COGNITIVE_REHAB
Laboratory Testing for Transplantation Rejection - (0465)
Policy ID: MM_0465
Tissue Engineered Skin Substitutes - (0068)
Policy ID: MM_0068

CPT Codes Commonly Billed with S31

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for S31

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.

ICD-10 S31, Billing FAQ

Is ICD-10 code S31 billable? +

No, S31 is a non-billable header code. Use a more specific child code from block S31 when submitting claims.

What codes are Type 1 Excludes for S31? +

Type 1 Excludes (never code together with S31): traumatic amputation of part of abdomen, lower back and pelvis (S38.2-, S38.3)

What codes are Type 2 Excludes for S31? +

Type 2 Excludes (may be coded together when both conditions exist): open wound of hip (S71.00-S71.02); open fracture of pelvis (S32.1--S32.9 with 7th character B)

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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