S02.40DS
S02.40DS — Maxillary fracture, left side, sequela
Billable / specific codeICD-10-CMPOA exemptleft
S02.40DS is a billable, specific ICD-10-CM code for maxillary fracture, left side, sequela. It is valid for submission on a claim.
7th character "S" — sequela
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
S02.40DS 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
S02.40DS 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.
- A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
- 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 S02.40D. If S02.40DS is not quite right, the correct code is usually one of these.
- S02.40DAMaxillary fracture, left side, initial encounter for closed fracture
- S02.40DBMaxillary fracture, left side, initial encounter for open fracture
- S02.40DDMaxillary fracture, left side, subsequent encounter for fracture with routine healing
- S02.40DGMaxillary fracture, left side, subsequent encounter for fracture with delayed healing
- S02.40DKMaxillary fracture, left side, subsequent encounter for fracture with nonunion
Questions about S02.40DS
- Is S02.40DS a billable ICD-10-CM code?
- Yes. S02.40DS is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S02.40DS 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).