ICD-10 S31.030
Non-Billable HeaderPuncture wound without foreign body of lower back and pelvis without penetration into retroperitoneum
About ICD-10-CM S31.030
ICD-10-CM code S31.030 represents Puncture wound without foreign body of lower back and pelvis without penetration into retroperitoneum. This is a non-billable header code in the Injury, Poisoning, and External Causes chapter (block S31). The 2026 edition of ICD-10-CM S31.030 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 S31.030
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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under S31.030. Per CMS ICD-10-CM Tabular 2026.
- Puncture wound without foreign body of lower back and pelvis NOS
Medicare LCD Coverage for S31.030
Local Coverage Determinations (LCDs) from CMS MACs that list S31.030 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 S31.030.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but S31.030 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with S31.030
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 S31.030
Other codes in section S30-S39 (Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals).
ICD-10 S31.030, Billing FAQ
Is ICD-10 code S31.030 billable? +
No, S31.030 is a non-billable header code. Use a more specific child code from block S31 when submitting claims.
What other names or terms map to S31.030? +
ICD-10 S31.030 includes: Puncture wound without foreign body of lower back and pelvis NOS.
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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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