S02.85 — Fracture of orbit, unspecified
S02.85 is a non-billable header ICD-10-CM code for fracture of orbit, unspecified. 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.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Fracture of orbit NOS
- Fracture of orbit wall NOS
Other codes that can never be billed with S02.85
These codes carry an Excludes1 note pointing at S02.85. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S02.85 alone.
- S02.3Fracture of orbital floor
Risk adjustment
S02.85 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 S02.85 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 S02.85.
- Fracture, traumatic›orbit, orbital(bone) (region)
- Fracture, traumatic›orbit, orbital›wall
Code to one of these instead S02.85
6 child codes. Green means billable.
- S02.85XAFracture of orbit, unspecified, initial encounter for closed fracture
- S02.85XBFracture of orbit, unspecified, initial encounter for open fracture
- S02.85XDFracture of orbit, unspecified, subsequent encounter for fracture with routine healing
- S02.85XGFracture of orbit, unspecified, subsequent encounter for fracture with delayed healing
- S02.85XKFracture of orbit, unspecified, subsequent encounter for fracture with nonunion
- S02.85XSFracture of orbit, unspecified, sequela
Related codes at this level
Codes that share S02.8. If S02.85 is not quite right, the correct code is usually one of these.
Questions about S02.85
- Is S02.85 a billable ICD-10-CM code?
- No. S02.85 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S02.85 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 S02.85?
- S02.85 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.