S02.400K
S02.400K — Malar fracture, unspecified side, subsequent encounter for fracture with nonunion
Billable / specific codeICD-10-CMPOA exemptunspecified
S02.400K is a billable, specific ICD-10-CM code for malar fracture, unspecified side, subsequent encounter for fracture with nonunion. It is valid for submission on a claim.
7th character "K" — subsequent encounter for fracture with nonunion
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
S02.400K 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
S02.400K 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 S02.400K is not quite right, the correct code is usually one of these.
- S02.400AMalar fracture, unspecified side, initial encounter for closed fracture
- S02.400BMalar fracture, unspecified side, initial encounter for open fracture
- S02.400DMalar fracture, unspecified side, subsequent encounter for fracture with routine healing
- S02.400GMalar fracture, unspecified side, subsequent encounter for fracture with delayed healing
- S02.400SMalar fracture, unspecified side, sequela
Questions about S02.400K
- Is S02.400K a billable ICD-10-CM code?
- Yes. S02.400K is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S02.400K 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).