Is S02.5XXD a billable ICD-10-CM code?

Yes. S02.5XXD is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S02.5XXD 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 S02.5XXD?

S02.5XXD carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

S02.5XXD

S02.5XXD — Fracture of tooth (traumatic), subsequent encounter for fracture with routine healing

Billable / specific codeICD-10-CMPOA exempt

S02.5XXD is a billable, specific ICD-10-CM code for fracture of tooth (traumatic), subsequent encounter for fracture with routine healing. It is valid for submission on a claim.

7th character "D" — subsequent encounter for fracture with routine healing

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

Risk adjustment

S02.5XXD 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

S02.5XXD 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.

A53065Billing and Coding: Outpatient Physical Therapy
A56658Billing and Coding: Cosmetic and Reconstructive Surgery
A57204Billing and Coding: MRI and CT Scans of the Head and Neck

Related codes at this level

Codes that share S02.5. If S02.5XXD is not quite right, the correct code is usually one of these.

Questions about S02.5XXD

Is S02.5XXD a billable ICD-10-CM code?: Yes. S02.5XXD is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S02.5XXD 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 S02.5XXD?: S02.5XXD carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.