S02.113S
S02.113S — Unspecified occipital condyle fracture, sequela
Billable / specific codeICD-10-CMPOA exempt
S02.113S is a billable, specific ICD-10-CM code for unspecified occipital condyle fracture, 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
S02.113S 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
S02.113S is named in 5 Medicare coverage policies — 5 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
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- A53065Billing and Coding: Outpatient Physical Therapy
- A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Related codes at this level
Codes that share S02.113. If S02.113S is not quite right, the correct code is usually one of these.
- S02.113AUnspecified occipital condyle fracture, initial encounter for closed fracture
- 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
Questions about S02.113S
- Is S02.113S a billable ICD-10-CM code?
- Yes. S02.113S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S02.113S 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).