What is the ICD-10-CM definition for S80.12XA?

Contusion of left lower leg, initial encounter. Official FY2027 CDC/NCHS clinical classification.

S80.12XA Billable Code FY2027 Status: Active

S80.12XA: Contusion of left lower leg, initial encounter

Contusion of left lower leg, initial encounter

Effective Date: 2026-10-01

Dataset: ICD-10-CM FY2027

Source: Centers for Disease Control and Prevention (CDC)

Last Verified: 2026-10-01

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Quick Clinical & Billing Summary

What is ICD-10-CM code S80.12XA? S80.12XA represents Contusion of left lower leg, initial encounter. Under official CDC guidelines, this code is billable and specific for claim submission.

Current release: FY2027 (Effective October 1, 2026). Sourced directly from CDC NCHS files.

Code Hierarchy & Classification

Chapter 19: Injury, poisoning and certain other consequences of external causes

⌊ Category S80: Superficial injury of knee and lower leg

⌊ S80.12XA: Contusion of left lower leg, initial encounter (Current Code)

Clinical Guidance & Documentation Standards

Clinical documentation should substantiate the medical necessity of this diagnosis, including laterality, anatomical site specificity, and clinical severity.

7th Character Episode of Care Builder

Chapter 19 Requirement

ICD-10-CM coding guidelines mandate assigning an appropriate 7th character for traumatic injuries, fractures, and external causes to denote the episode of care:

A Initial Encounter

Patient receiving active clinical treatment (surgical evaluation, emergency care, initial casting).

D Subsequent Encounter

Patient receiving routine care during healing phase (cast change, medication adjustment, follow-up).

S Sequela (Late Effect)

Complications or conditions arising as a direct late consequence of the healed injury.

Placeholder X Rule: If the diagnosis code has fewer than 6 characters, you must append placeholder 'X' characters to maintain the 7th character position. Use 7th Character Builder Tool →

Associated Procedures & Medicare RVU Reimbursement

Open RVU Calculator →

Typical outpatient and office evaluation procedures frequently billed alongside diagnosis S80.12XA:

CPT/HCPCS	Description	Work RVU	Non-Facility Fee	Facility Fee
99213	Office/outpatient visit, established patient, 20-29 minutes (Low MDM)	1.30	$91.69	$66.79
99214	Office/outpatient visit, established patient, 30-39 minutes (Moderate MDM)	1.92	$133.61	$100.21
96372	Therapeutic, prophylactic, or diagnostic injection (subcutaneous/intramuscular)	0.17	$18.34	$12.44

Based on official CMS 2026 Physician Fee Schedule conversion factor ($32.7476). Payments vary by locality GPCI.

CPT Modifier & Billing Rules

Modifier 25 Significant E/M

Append when a significant, separately identifiable evaluation and management service is provided on the same calendar day as a minor surgical procedure or injection.

Modifier 59 Distinct Service

Identifies procedures or services not normally reported together but distinct under the clinical circumstances. Use CMS X-modifiers (XE, XS, XP, XU) where required by Medicare.

Check NCCI Procedure to Procedure (PTP) unbundling rules in NCCI Checker →

Frequently Asked Questions about S80.12XA

Is S80.12XA a billable ICD-10 code?

Yes, S80.12XA is a valid, billable and specific ICD-10-CM code. It can be reported as a primary or secondary diagnosis on medical claims.

What is the ICD-10 code for Contusion of left lower leg, initial encounter?

The primary ICD-10-CM code for Contusion of left lower leg, initial encounter is S80.12XA.

What is the effective date of the current S80.12XA code?

The code is active for fiscal year FY2027, effective starting 2026-10-01.

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Official Provenance: Sourced from CDC / NCHS FY2027 ICD-10-CM files. Report a Data Error

Verified: 2026-10-01