S02.122B — Fracture of orbital roof, left side, initial encounter for open fracture
S02.122B is a billable, specific ICD-10-CM code for fracture of orbital roof, 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
Excludes2 inherited from the categories above S02.122B
Also inherited, and the opposite of Excludes1: these conditions are not part of S02.122B, but a patient can have both, so you may code both.
Other codes that can never be billed with S02.122B
These codes carry an Excludes1 note pointing at S02.122B. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S02.122B alone.
- S01Open wound of head
Risk adjustment
S02.122B 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
S02.122B is named in 9 Medicare coverage policies — 9 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
- A53064Billing and Coding: Outpatient Occupational Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
Code history
S02.122B has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share S02.122. If S02.122B is not quite right, the correct code is usually one of these.
- S02.122AFracture of orbital roof, left side, initial encounter for closed 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
Questions about S02.122B
- Is S02.122B a billable ICD-10-CM code?
- Yes. S02.122B is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S02.122B 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).