S09.19XA: Other specified injury of muscle and tendon of head, initial encounter
S09.19XA, other specified injury of muscle and tendon of head, initial encounter, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 12 HCPCS Level II codes, including Q2028 (Injection, sculptra, 0.5 mg), G0429 (Dermal filler injection(s) for the treatment of facial…), Q2026 (Injection, radiesse, 0.1 ml). 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 S09.19XA as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| Q2028 | Injection, sculptra, 0.5 mg | Special coverage instructions apply | — | 2 |
| G0429 | Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy) | Carrier judgment | — | 2 |
| Q2026 | Injection, radiesse, 0.1 ml | Special coverage instructions apply | — | 2 |
| G2187 | Patients with clinical indications for imaging of the head: head trauma | Carrier judgment | — | 1 |
| G2188 | Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age | Carrier judgment | — | 1 |
| G2189 | Patients with clinical indications for imaging of the head: abnormal neurologic exam | Carrier judgment | — | 1 |
| G2190 | Patients with clinical indications for imaging of the head: headache radiating to the neck | Carrier judgment | — | 1 |
| G2191 | Patients with clinical indications for imaging of the head: positional headaches | Carrier judgment | — | 1 |
| G2192 | Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age | Carrier judgment | — | 1 |
| G2193 | Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age) | Carrier judgment | — | 1 |
| G2194 | Patients with clinical indications for imaging of the head: new onset headache in pediatric patients with disabilities for which headache is a concern as inferred from behavior | Carrier judgment | — | 1 |
| G2195 | Patients with clinical indications for imaging of the head: occipital headache in children | Carrier judgment | — | 1 |
Medicare policy articles listing S09.19XA
- A59299: Billing and Coding: Cosmetic and Reconstructive Surgery (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33428, L35090, L38914, L39051
- A58774: Billing and Coding: Cosmetic and Reconstructive Surgery (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33428, L35090, L38914, L39051
- A56612: Billing and Coding: CT of the Head (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L34417
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 S09 diagnoses (Other and unspecified injuries of head)
- S09.11XA — Strain of muscle and tendon of head, initial encounter
- S09.12XA — Laceration of muscle and tendon of head, initial encounter
- S09.0XXA — Injury of blood vessels of head, not elsewhere classified, initial…
- S09.311A — Primary blast injury of right ear, initial encounter
- S09.312A — Primary blast injury of left ear, initial encounter
- S09.313A — Primary blast injury of ear, bilateral, initial encounter
- S09.8XXA — Other specified injuries of head, initial encounter
Frequently asked questions
Does Medicare cover S09.19XA (Other specified injury of muscle and tendon of head…)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list S09.19XA as a covered diagnosis for 12 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 S09.19XA?
The Level II codes from the policies most specific to this diagnosis are Q2028 (Injection, sculptra, 0.5 mg, 2 articles); G0429 (Dermal filler injection(s) for the treatment of facial…, 2 articles); Q2026 (Injection, radiesse, 0.1 ml, 2 articles); G2187 (Patients with clinical indications for imaging of the…, 1 article); G2188 (Patients with clinical indications for imaging of the…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list S09.19XA?
A59299 (Billing and Coding: Cosmetic and Reconstructive Surgery); A58774 (Billing and Coding: Cosmetic and Reconstructive Surgery); A56612 (Billing and Coding: CT of the Head).
What is ICD-10-CM code S09.19XA?
S09.19XA is the ICD-10-CM code for other specified injury of muscle and tendon of head, initial encounter, in category S09 (Other and unspecified injuries of head), chapter 19: Injury, poisoning and other consequences of external causes.
Next steps
- Run a reimbursement report for a device billed under Q2028
- Watch Q2028 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q2028
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