Is S02.31XA a billable ICD-10-CM code?

Yes. S02.31XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S02.31XA 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).

S02.31XA

S02.31XA — Fracture of orbital floor, right side, initial encounter for closed fracture

Billable / specific codeICD-10-CMright

S02.31XA is a billable, specific ICD-10-CM code for fracture of orbital floor, right side, 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

S02.31XA 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

S02.31XA is named in 4 Medicare coverage policies — 4 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
A56729Billing and Coding: Magnetic Resonance Imaging of the Head and Neck
A57068Billing and Coding: Ocular Photography - External
A57204Billing and Coding: MRI and CT Scans of the Head and Neck

Related codes at this level

Codes that share S02.31. If S02.31XA is not quite right, the correct code is usually one of these.

Questions about S02.31XA

Is S02.31XA a billable ICD-10-CM code?: Yes. S02.31XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S02.31XA 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).