S02.11FB — Type III occipital condyle fracture, left side, initial encounter for open fracture
S02.11FB is a billable, specific ICD-10-CM code for type iii occipital condyle fracture, left side, initial encounter for open fracture. It is valid for submission on a claim.
7th character "B" — initial encounter for open 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
S02.11FB 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
S02.11FB 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.
- A54767Billing and Coding: Medicare Preventive Coverage for Certain Vaccines
- A56612Billing and Coding: CT of the Head
- A56900Billing and Coding: Immunizations
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
Related codes at this level
Codes that share S02.11F. If S02.11FB is not quite right, the correct code is usually one of these.
- S02.11FAType III occipital condyle fracture, left side, initial encounter for closed fracture
- S02.11FDType III occipital condyle fracture, left side, subsequent encounter for fracture with routine healing
- S02.11FGType III occipital condyle fracture, left side, subsequent encounter for fracture with delayed healing
- S02.11FKType III occipital condyle fracture, left side, subsequent encounter for fracture with nonunion
- S02.11FSType III occipital condyle fracture, left side, sequela
Questions about S02.11FB
- Is S02.11FB a billable ICD-10-CM code?
- Yes. S02.11FB is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S02.11FB 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).