S02.122A: Fracture of orbital roof, left side, initial encounter for closed fracture
S02.122A is a billable, specific ICD-10-CM code for fracture of orbital roof, left side, initial encounter for closed fracture. It is valid for submission on a claim.
Check S02.122A with the rest of the claim: free scrubber7th 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
Other codes that can never be billed with S02.122A
Their own Excludes1 notes name this code, so the conflict is not listed above.
- S01Open wound of head
Risk adjustment
S02.122A 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
S02.122A is named in 5 Medicare coverage policies: 5 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A53057Billing and Coding: Home Health Occupational Therapy
- A53058Billing and Coding: Home Health Physical Therapy
- A53064Billing and Coding: Outpatient Occupational Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under S02.122
- S02.122BFracture of orbital roof, left side, initial encounter for open fracture
- S02.122DFracture of orbital roof, left side, subsequent encounter for fracture with routine healing
- S02.122GFracture of orbital roof, left side, subsequent encounter for fracture with delayed healing
- S02.122KFracture of orbital roof, left side, subsequent encounter for fracture with nonunion
- S02.122SFracture of orbital roof, left side, sequela