S21.012A: Laceration without foreign body of left breast, initial encounter

S21.012A, laceration without foreign body of left breast, initial encounter, is listed as a covered diagnosis in 5 Medicare billing and coding articles that apply to 36 HCPCS Level II codes, including G0279 (Diagnostic digital breast tomosynthesis, unilateral or…), C8903 (Magnetic resonance imaging with contrast, breast; unilateral), C8905 (Magnetic resonance imaging without contrast followed by…). 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 S21.012A as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
G0279Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)Carrier judgment—1
C8903Magnetic resonance imaging with contrast, breast; unilateralSpecial coverage instructions apply—1
C8905Magnetic resonance imaging without contrast followed by with contrast, breast; unilateralSpecial coverage instructions apply—1
C8906Magnetic resonance imaging with contrast, breast; bilateralSpecial coverage instructions apply—1
C8908Magnetic resonance imaging without contrast followed by with contrast, breast; bilateralSpecial coverage instructions apply—1
J1670Injection, tetanus immune globulin, human, up to 250 unitsSpecial coverage instructions apply—2
J1575Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulinCarrier judgment—1
J1569Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mgSpecial coverage instructions apply—1
J1561Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mgSpecial coverage instructions apply—1
J1459Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—1
J1557Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—1
J1556Injection, immune globulin (bivigam), 500 mgCarrier judgment—1
J1568Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—1
J1566Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mgSpecial coverage instructions apply—1
J1554Injection, immune globulin (asceniv), 500 mgCarrier judgment—1
J1599Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mgCarrier judgment—1
J1572Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mgSpecial coverage instructions apply—1
J1460Injection, gamma globulin, intramuscular, 1 ccSpecial coverage instructions apply—1
J0840Injection, crotalidae polyvalent immune fab (ovine), up to 1 gramCarrier judgment—1
J0850Injection, cytomegalovirus immune globulin intravenous (human), per vialSpecial coverage instructions apply—1
J1552Injection, immune globulin (alyglo), 500 mgCarrier judgment—1
J1560Injection, gamma globulin, intramuscular, over 10 ccSpecial coverage instructions apply—1
J1571Injection, hepatitis b immune globulin (hepagam b), intramuscular, 0.5 mlSpecial coverage instructions apply—1
J1573Injection, hepatitis b immune globulin (hepagam b), intravenous, 0.5 mlCarrier judgment—1
J1577Injection, immune globulin (qivigy), 100 mgCarrier judgment—1

11 more codes are listed. See every code with payment by region in Caduvo.

Medicare policy articles listing S21.012A

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 S21 diagnoses (Open wound of thorax)

Frequently asked questions

Does Medicare cover S21.012A (Laceration without foreign body of left breast, initial…)?

Medicare covers items and services, not diagnoses. 5 Medicare billing and coding articles list S21.012A as a covered diagnosis for 36 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 S21.012A?

The Level II codes from the policies most specific to this diagnosis are G0279 (Diagnostic digital breast tomosynthesis, unilateral or…, 1 article); C8903 (Magnetic resonance imaging with contrast, breast; unilateral, 1 article); C8905 (Magnetic resonance imaging without contrast followed by…, 1 article); C8906 (Magnetic resonance imaging with contrast, breast; bilateral, 1 article); C8908 (Magnetic resonance imaging without contrast followed by…, 1 article). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list S21.012A?

A56448 (Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography); A57554 (Billing and Coding: Immune Globulins); A55909 (Billing and Coding: Wound Care), and 2 more articles.

What is ICD-10-CM code S21.012A?

S21.012A is the ICD-10-CM code for laceration without foreign body of left breast, initial encounter, in category S21 (Open wound of thorax), chapter 19: Injury, poisoning and other consequences of external causes.

Next steps

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