Is S02.85XD a billable ICD-10-CM code?

Yes. S02.85XD is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S02.85XD 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 S02.85XD?

S02.85XD carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

S02.85XD

S02.85XD — Fracture of orbit, unspecified, subsequent encounter for fracture with routine healing

Billable / specific codeICD-10-CMPOA exempt

S02.85XD is a billable, specific ICD-10-CM code for fracture of orbit, unspecified, 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.

lateral orbital wall (S02.84-)
medial orbital wall (S02.83-)
orbital floor (S02.3-)
orbital roof (S02.12-)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Fracture of orbit NOS
Fracture of orbit wall NOS

Risk adjustment

S02.85XD 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

S02.85XD 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

Related codes at this level

Codes that share S02.85. If S02.85XD is not quite right, the correct code is usually one of these.

Questions about S02.85XD

Is S02.85XD a billable ICD-10-CM code?: Yes. S02.85XD is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S02.85XD 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 S02.85XD?: S02.85XD carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.