Is S02.400G a billable ICD-10-CM code?

Yes. S02.400G is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S02.400G 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).

S02.400G

S02.400G — Malar fracture, unspecified side, subsequent encounter for fracture with delayed healing

Billable / specific codeICD-10-CMPOA exemptunspecified

S02.400G is a billable, specific ICD-10-CM code for malar fracture, unspecified side, subsequent encounter for fracture with delayed healing. It is valid for submission on a claim.

7th character "G" — subsequent encounter for fracture with delayed healing

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

S02.400G does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

S02.400G 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.

A53058Billing and Coding: Home Health Physical Therapy
A53065Billing and Coding: Outpatient Physical Therapy
A56612Billing and Coding: CT of the Head
A57204Billing and Coding: MRI and CT Scans of the Head and Neck

Related codes at this level

Codes that share S02.400. If S02.400G is not quite right, the correct code is usually one of these.

Questions about S02.400G

Is S02.400G a billable ICD-10-CM code?: Yes. S02.400G is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S02.400G 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).