Is S02.401 a billable ICD-10-CM code?

No. S02.401 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does S02.401 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).

S02.401

S02.401 — Maxillary fracture, unspecified side

Non-billable headerICD-10-CMunspecified

S02.401 is a non-billable header ICD-10-CM code for maxillary fracture, unspecified side. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

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

S02.401 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.

How S02.401 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to S02.401.

Fracture, traumatic›maxilla, maxillary(bone) (sinus) (superior) (upper jaw)

Code to one of these instead S02.401

6 child codes. Green means billable.

Related codes at this level

Codes that share S02.40. If S02.401 is not quite right, the correct code is usually one of these.

Questions about S02.401

Is S02.401 a billable ICD-10-CM code?: No. S02.401 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does S02.401 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).