Is S02.111S a billable ICD-10-CM code?

Yes. S02.111S is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S02.111S sit in the tabular list?

Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the head (S00-S09).

S02.111S

S02.111S — Type II occipital condyle fracture, unspecified side, sequela

Billable / specific codeICD-10-CMPOA exemptunspecified

S02.111S is a billable, specific ICD-10-CM code for type ii occipital condyle fracture, unspecified side, sequela. It is valid for submission on a claim.

7th character "S" — sequela

The appropriate 7th character is to be added to each code from category S02

A: initial encounter for closed fracture
B: initial encounter for open fracture
D: subsequent encounter for fracture with routine healing
G: subsequent encounter for fracture with delayed healing
K: subsequent encounter for fracture with nonunion
S: sequela

Risk adjustment

S02.111S does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

S02.111S is named in 6 Medicare coverage policies — 6 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A53057Billing and Coding: Home Health Occupational Therapy
A53058Billing and Coding: Home Health Physical Therapy
A53065Billing and Coding: Outpatient Physical Therapy
A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders

Related codes at this level

Codes that share S02.111. If S02.111S is not quite right, the correct code is usually one of these.

Questions about S02.111S

Is S02.111S a billable ICD-10-CM code?: Yes. S02.111S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S02.111S sit in the tabular list?: Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the head (S00-S09).