Is S02.413S a billable ICD-10-CM code?

Yes. S02.413S is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S02.413S 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).

S02.413S

S02.413S — LeFort III fracture, sequela

Billable / specific codeICD-10-CMPOA exempt

S02.413S is a billable, specific ICD-10-CM code for lefort iii fracture, 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

S02.413S 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

S02.413S is named in 6 Medicare coverage policies — 6 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

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Related codes at this level

Codes that share S02.413. If S02.413S is not quite right, the correct code is usually one of these.

Questions about S02.413S

Is S02.413S a billable ICD-10-CM code?: Yes. S02.413S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S02.413S 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).