S02.113A — Unspecified occipital condyle fracture, initial encounter for closed fracture
S02.113A is a billable, specific ICD-10-CM code for unspecified occipital condyle fracture, initial encounter for closed fracture. It is valid for submission on a claim.
7th character "A" — initial encounter for closed fracture
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
S02.113A risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 399 Major Head Injury without Loss of Consciousness0.199 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
S02.113A is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56612Billing and Coding: CT of the Head
Related codes at this level
Codes that share S02.113. If S02.113A is not quite right, the correct code is usually one of these.
- S02.113BUnspecified occipital condyle fracture, initial encounter for open fracture
- S02.113DUnspecified occipital condyle fracture, subsequent encounter for fracture with routine healing
- S02.113GUnspecified occipital condyle fracture, subsequent encounter for fracture with delayed healing
- S02.113KUnspecified occipital condyle fracture, subsequent encounter for fracture with nonunion
- S02.113SUnspecified occipital condyle fracture, sequela
Questions about S02.113A
- Is S02.113A a billable ICD-10-CM code?
- Yes. S02.113A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S02.113A 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).