S02.831B: Fracture of medial orbital wall, right side, initial encounter for open fracture
S02.831B is a billable, specific ICD-10-CM code for fracture of medial orbital wall, right side, initial encounter for open fracture. It is valid for submission on a claim.
Check S02.831B with the rest of the claim: free scrubber7th character "B": initial encounter for open 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
Excludes2 inherited from the categories above S02.831B
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with S02.831B
Their own Excludes1 notes name this code, so the conflict is not listed above.
- S01Open wound of head
Risk adjustment
S02.831B 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
S02.831B is named in 9 Medicare coverage policies: 9 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A53058Billing and Coding: Home Health Physical Therapy
- A53064Billing and Coding: Outpatient Occupational Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
- A54767Billing and Coding: Medicare Preventive Coverage for Certain Vaccines
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under S02.831
- S02.831AFracture of medial orbital wall, right side, initial encounter for closed fracture
- S02.831DFracture of medial orbital wall, right side, subsequent encounter for fracture with routine healing
- S02.831GFracture of medial orbital wall, right side, subsequent encounter for fracture with delayed healing
- S02.831KFracture of medial orbital wall, right side, subsequent encounter for fracture with nonunion
- S02.831SFracture of medial orbital wall, right side, sequela