S02.40BA — Malar fracture, left side, initial encounter for closed fracture
S02.40BA is a billable, specific ICD-10-CM code for malar fracture, left 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
S02.40BA 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
S02.40BA is named in 3 Medicare coverage policies — 3 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
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
Related codes at this level
Codes that share S02.40B. If S02.40BA is not quite right, the correct code is usually one of these.
- S02.40BBMalar fracture, left side, initial encounter for open fracture
- S02.40BDMalar fracture, left side, subsequent encounter for fracture with routine healing
- S02.40BGMalar fracture, left side, subsequent encounter for fracture with delayed healing
- S02.40BKMalar fracture, left side, subsequent encounter for fracture with nonunion
- S02.40BSMalar fracture, left side, sequela
Questions about S02.40BA
- Is S02.40BA a billable ICD-10-CM code?
- Yes. S02.40BA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S02.40BA 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).