S01.121A: Laceration with foreign body of right eyelid and periocular area, initial encounter
S01.121A, laceration with foreign body of right eyelid and periocular area, initial encounter, is listed as a covered diagnosis in 4 Medicare billing and coding articles that apply to 31 HCPCS Level II codes, including J1670 (Injection, tetanus immune globulin, human, up to 250 units), J1575 (Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg…), J1569 (Injection, immune globulin, (gammagard liquid/gammagard…). The articles come from 3 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with S01.121A as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J1670 | Injection, tetanus immune globulin, human, up to 250 units | Special coverage instructions apply | — | 2 |
| J1575 | Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin | Carrier judgment | — | 1 |
| J1569 | Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mg | Special coverage instructions apply | — | 1 |
| J1561 | Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg | Special coverage instructions apply | — | 1 |
| J1459 | Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg | Carrier judgment | — | 1 |
| J1557 | Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mg | Carrier judgment | — | 1 |
| J1556 | Injection, immune globulin (bivigam), 500 mg | Carrier judgment | — | 1 |
| J1568 | Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg | Carrier judgment | — | 1 |
| J1566 | Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg | Special coverage instructions apply | — | 1 |
| J1554 | Injection, immune globulin (asceniv), 500 mg | Carrier judgment | — | 1 |
| J1599 | Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mg | Carrier judgment | — | 1 |
| J1572 | Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg | Special coverage instructions apply | — | 1 |
| J1460 | Injection, gamma globulin, intramuscular, 1 cc | Special coverage instructions apply | — | 1 |
| J0840 | Injection, crotalidae polyvalent immune fab (ovine), up to 1 gram | Carrier judgment | — | 1 |
| J0850 | Injection, cytomegalovirus immune globulin intravenous (human), per vial | Special coverage instructions apply | — | 1 |
| J1552 | Injection, immune globulin (alyglo), 500 mg | Carrier judgment | — | 1 |
| J1560 | Injection, gamma globulin, intramuscular, over 10 cc | Special coverage instructions apply | — | 1 |
| J1571 | Injection, hepatitis b immune globulin (hepagam b), intramuscular, 0.5 ml | Special coverage instructions apply | — | 1 |
| J1573 | Injection, hepatitis b immune globulin (hepagam b), intravenous, 0.5 ml | Carrier judgment | — | 1 |
| J1577 | Injection, immune globulin (qivigy), 100 mg | Carrier judgment | — | 1 |
| G0281 | Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| G0329 | Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care | Carrier judgment | — | 1 |
| G0008 | Administration of influenza virus vaccine | Carrier judgment | — | 1 |
| G0009 | Administration of pneumococcal vaccine | Carrier judgment | — | 1 |
| G0010 | Administration of hepatitis b vaccine | Carrier judgment | — | 1 |
6 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing S01.121A
- A57554: Billing and Coding: Immune Globulins (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 20 Level II codes). LCD with the same title: L34771
- A55909: Billing and Coding: Wound Care (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L35125, L37166, L37228
- A52438: Billing and Coding: Tetanus Immunization (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes)
- A54767: Billing and Coding: Medicare Preventive Coverage for Certain Vaccines (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes)
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other S01 diagnoses (Open wound of head)
- S01.122A — Laceration with foreign body of left eyelid and periocular area…
- S01.101A — Unspecified open wound of right eyelid and periocular area, initial…
- S01.102A — Unspecified open wound of left eyelid and periocular area, initial…
- S01.111A — Laceration without foreign body of right eyelid and periocular area…
- S01.112A — Laceration without foreign body of left eyelid and periocular area…
- S01.131A — Puncture wound without foreign body of right eyelid and periocular…
- S01.132A — Puncture wound without foreign body of left eyelid and periocular…
- S01.141A — Puncture wound with foreign body of right eyelid and periocular…
- S01.142A — Puncture wound with foreign body of left eyelid and periocular area…
- S01.151A — Open bite of right eyelid and periocular area, initial encounter
- S01.152A — Open bite of left eyelid and periocular area, initial encounter
- S01.01XA — Laceration without foreign body of scalp, initial encounter
- S01.02XA — Laceration with foreign body of scalp, initial encounter
- S01.03XA — Puncture wound without foreign body of scalp, initial encounter
- S01.04XA — Puncture wound with foreign body of scalp, initial encounter
- S01.05XA — Open bite of scalp, initial encounter
- S01.21XA — Laceration without foreign body of nose, initial encounter
- S01.22XA — Laceration with foreign body of nose, initial encounter
- S01.23XA — Puncture wound without foreign body of nose, initial encounter
- S01.24XA — Puncture wound with foreign body of nose, initial encounter
- S01.25XA — Open bite of nose, initial encounter
- S01.301A — Unspecified open wound of right ear, initial encounter
- S01.302A — Unspecified open wound of left ear, initial encounter
- S01.311A — Laceration without foreign body of right ear, initial encounter
- S01.312A — Laceration without foreign body of left ear, initial encounter
- S01.321A — Laceration with foreign body of right ear, initial encounter
- S01.322A — Laceration with foreign body of left ear, initial encounter
- S01.331A — Puncture wound without foreign body of right ear, initial encounter
- S01.332A — Puncture wound without foreign body of left ear, initial encounter
- S01.341A — Puncture wound with foreign body of right ear, initial encounter
Frequently asked questions
Does Medicare cover S01.121A (Laceration with foreign body of right eyelid and…)?
Medicare covers items and services, not diagnoses. 4 Medicare billing and coding articles list S01.121A as a covered diagnosis for 31 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 S01.121A?
The Level II codes from the policies most specific to this diagnosis are J1670 (Injection, tetanus immune globulin, human, up to 250 units, 2 articles); J1575 (Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg…, 1 article); J1569 (Injection, immune globulin, (gammagard liquid/gammagard…, 1 article); J1561 (Injection, immune globulin, (gamunex-c/gammaked)…, 1 article); J1459 (Injection, immune globulin (privigen), intravenous…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list S01.121A?
A57554 (Billing and Coding: Immune Globulins); A55909 (Billing and Coding: Wound Care); A52438 (Billing and Coding: Tetanus Immunization), and 1 more article.
What is ICD-10-CM code S01.121A?
S01.121A is the ICD-10-CM code for laceration with foreign body of right eyelid and periocular area, initial encounter, in category S01 (Open wound of head), chapter 19: Injury, poisoning and other consequences of external causes.
Next steps
- Run a reimbursement report for a device billed under J1670
- Watch J1670 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1670
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 19: Injury, poisoning and other consequences of external causes · All diagnoses · HCPCS lookup