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

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

Where does S02.31XB 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).

What cannot be coded together with S02.31XB?

S02.31XB carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S02.31XB (S02.3) and apply to it just the same.

S02.31XB

S02.31XB — Fracture of orbital floor, right side, initial encounter for open fracture

Billable / specific codeICD-10-CMright

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

Excludes1 inherited from the categories above S02.31XB

These are not written on S02.31XB, but they bind it: a note on a category applies to every code beneath it. Billing S02.31XB with anything listed here is a denial.

Written on S02.3 — Fracture of orbital floor

orbit NOS (S02.85)

Excludes2 inherited from the categories above S02.31XB

Also inherited, and the opposite of Excludes1: these conditions are not part of S02.31XB, but a patient can have both, so you may code both.

Written on S02.3 — Fracture of orbital floor

lateral orbital wall (S02.84-)
medial orbital wall (S02.83-)
orbital roof (S02.1-)

Other codes that can never be billed with S02.31XB

These codes carry an Excludes1 note pointing at S02.31XB. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S02.31XB alone.

S01Open wound of head

Risk adjustment

S02.31XB 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

S02.31XB is named in 8 Medicare coverage policies — 8 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
A56729Billing and Coding: Magnetic Resonance Imaging of the Head and Neck
A56900Billing and Coding: Immunizations

Code history

S02.31XB 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 S02.31. If S02.31XB is not quite right, the correct code is usually one of these.

Questions about S02.31XB

Is S02.31XB a billable ICD-10-CM code?: Yes. S02.31XB is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S02.31XB 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).
What cannot be coded together with S02.31XB?: S02.31XB carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S02.31XB (S02.3) and apply to it just the same.