Is S02.849A a billable ICD-10-CM code?

Yes. S02.849A is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S02.849A 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).

S02.849A

S02.849A — Fracture of lateral orbital wall, unspecified side, initial encounter for closed fracture

Billable / specific codeICD-10-CMunspecified

S02.849A is a billable, specific ICD-10-CM code for fracture of lateral orbital wall, unspecified side, initial encounter for closed fracture. It is valid for submission on a claim.

7th character "A" — initial encounter for closed 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 S02.849A

Also inherited, and the opposite of Excludes1: these conditions are not part of S02.849A, but a patient can have both, so you may code both.

Written on S02.84 — Fracture of lateral orbital wall

orbital floor (S02.3-)
orbital roof (S02.12-)

Written on S02.8 — Fractures of other specified skull and facial bones

fracture of orbital floor (S02.3-)
fracture of orbital roof (S02.12-)

Other codes that can never be billed with S02.849A

These codes carry an Excludes1 note pointing at S02.849A. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S02.849A alone.

S01Open wound of head

Risk adjustment

S02.849A 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.

Medicare coverage

S02.849A is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56612Billing and Coding: CT of the Head
A56729Billing and Coding: Magnetic Resonance Imaging of the Head and Neck

Code history

S02.849A has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share S02.849. If S02.849A is not quite right, the correct code is usually one of these.

Questions about S02.849A

Is S02.849A a billable ICD-10-CM code?: Yes. S02.849A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S02.849A 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).