S02.849A: Fracture of lateral orbital wall, unspecified side, initial encounter for closed fracture
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.
Check S02.849A with the rest of the claim: free scrubber7th 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
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with S02.849A
Their own Excludes1 notes name this code, so the conflict is not listed above.
- 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
S02.849A is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56612Billing and Coding: CT of the Head
- A56729Billing and Coding: Magnetic Resonance Imaging of the Head and Neck
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under S02.849
- S02.849BFracture of lateral orbital wall, unspecified side, initial encounter for open fracture
- S02.849DFracture of lateral orbital wall, unspecified side, subsequent encounter for fracture with routine healing
- S02.849GFracture of lateral orbital wall, unspecified side, subsequent encounter for fracture with delayed healing
- S02.849KFracture of lateral orbital wall, unspecified side, subsequent encounter for fracture with nonunion
- S02.849SFracture of lateral orbital wall, unspecified side, sequela