S02.5 — Fracture of tooth (traumatic)
S02.5 is a non-billable header ICD-10-CM code for fracture of tooth (traumatic). 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
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- cracked tooth (nontraumatic) (K03.81)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Broken tooth
Other codes that can never be billed with S02.5
These codes carry an Excludes1 note pointing at S02.5. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S02.5 alone.
Risk adjustment
S02.5 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 S02.5 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 S02.5.
- Fracture, traumatic›tooth(root)
Code to one of these instead S02.5
6 child codes. Green means billable.
- S02.5XXAFracture of tooth (traumatic), initial encounter for closed fracture
- S02.5XXBFracture of tooth (traumatic), initial encounter for open fracture
- S02.5XXDFracture of tooth (traumatic), subsequent encounter for fracture with routine healing
- S02.5XXGFracture of tooth (traumatic), subsequent encounter for fracture with delayed healing
- S02.5XXKFracture of tooth (traumatic), subsequent encounter for fracture with nonunion
- S02.5XXSFracture of tooth (traumatic), sequela
Related codes at this level
Codes that share S02. If S02.5 is not quite right, the correct code is usually one of these.
- S02.0Fracture of vault of skull
- S02.1Fracture of base of skull
- S02.2Fracture of nasal bones
- S02.3Fracture of orbital floor
- S02.4Fracture of malar, maxillary and zygoma bones
- S02.6Fracture of mandible
- S02.8Fractures of other specified skull and facial bones
- S02.9Fracture of unspecified skull and facial bones
Questions about S02.5
- Is S02.5 a billable ICD-10-CM code?
- No. S02.5 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S02.5 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).
- What cannot be coded together with S02.5?
- S02.5 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.