S31.011A: Laceration without foreign body of lower back and pelvis with penetration into retroperitoneum, initial encounter

S31.011A, laceration without foreign body of lower back and pelvis with penetration into retroperitoneum, initial encounter, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 16 HCPCS Level II codes, including G0329 (Electromagnetic therapy, to one or more areas for chronic…), G0281 (Electrical stimulation, (unattended), to one or more…), G0008 (Administration of influenza virus vaccine). The articles come from 2 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 S31.011A as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
G0329Electromagnetic 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 careCarrier judgment—2
G0281Electrical 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 careCarrier judgment—1
G0008Administration of influenza virus vaccineCarrier judgment—1
G0009Administration of pneumococcal vaccineCarrier judgment—1
G0010Administration of hepatitis b vaccineCarrier judgment—1
Q2038Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone)Special coverage instructions apply—1
Q2035Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria)Special coverage instructions apply—1
Q2037Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin)Special coverage instructions apply—1
Q2034Influenza virus vaccine, split virus, for intramuscular use (agriflu)Special coverage instructions apply—1
Q2036Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval)Special coverage instructions apply—1
Q2039Influenza virus vaccine, not otherwise specifiedSpecial coverage instructions apply—1
G0151Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutesCarrier judgment—1
G0157Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutesCarrier judgment—1
G0159Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutesCarrier judgment—1
G2168Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program, each 15 minutesCarrier judgment—1
L1972Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, off-the shelfCarrier judgment—1

Medicare policy articles listing S31.011A

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 S31 diagnoses (Open wound of abdomen, lower back, pelvis and external genitals)

Frequently asked questions

Does Medicare cover S31.011A (Laceration without foreign body of lower back and pelvis…)?

Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list S31.011A as a covered diagnosis for 16 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 S31.011A?

The Level II codes from the policies most specific to this diagnosis are G0329 (Electromagnetic therapy, to one or more areas for chronic…, 2 articles); G0281 (Electrical stimulation, (unattended), to one or more…, 1 article); G0008 (Administration of influenza virus vaccine, 1 article); G0009 (Administration of pneumococcal vaccine, 1 article); G0010 (Administration of hepatitis b vaccine, 1 article). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list S31.011A?

A55909 (Billing and Coding: Wound Care); A54767 (Billing and Coding: Medicare Preventive Coverage for Certain Vaccines); A53058 (Billing and Coding: Home Health Physical Therapy).

What is ICD-10-CM code S31.011A?

S31.011A is the ICD-10-CM code for laceration without foreign body of lower back and pelvis with penetration into retroperitoneum, initial encounter, in category S31 (Open wound of abdomen, lower back, pelvis and external genitals), chapter 19: Injury, poisoning and other consequences of external causes.

Next steps

Compiled by Caduvo from public CMS (Medicare) records, ICD-10-CM FY2026, HCPCS release October 2026, 2026 fee schedule (non-rural state fees). Not reviewed or endorsed by CMS. Not billing or legal advice. Report an error. Data and corrections policy.

Chapter 19: Injury, poisoning and other consequences of external causes · All diagnoses · HCPCS lookup