Is S82.1 a billable ICD-10-CM code?

No. S82.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does S82.1 sit in the tabular list?

Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the knee and lower leg (S80-S89).

S82.1

S82.1 — Fracture of upper end of tibia

Non-billable headerICD-10-CM

S82.1 is a non-billable header ICD-10-CM code for fracture of upper end of tibia. 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 all codes from category S82

A: initial encounter for closed fracture
B: initial encounter for open fracture type I or II
C: initial encounter for open fracture type IIIA, IIIB, or IIIC
D: subsequent encounter for closed fracture with routine healing
E: subsequent encounter for open fracture type I or II with routine healing
F: subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
G: subsequent encounter for closed fracture with delayed healing
H: subsequent encounter for open fracture type I or II with delayed healing
J: subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
K: subsequent encounter for closed fracture with nonunion
M: subsequent encounter for open fracture type I or II with nonunion
N: subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
P: subsequent encounter for closed fracture with malunion
Q: subsequent encounter for open fracture type I or II with malunion
R: subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
S: sequela

Excludes2 — not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

fracture of shaft of tibia (S82.2-)
physeal fracture of upper end of tibia (S89.0-)

Inclusion terms

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

Fracture of proximal end of tibia

Risk adjustment

S82.1 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.

Code to one of these instead S82.1

8 child codes. Green means billable.

Related codes at this level

Codes that share S82. If S82.1 is not quite right, the correct code is usually one of these.

Questions about S82.1

Is S82.1 a billable ICD-10-CM code?: No. S82.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does S82.1 sit in the tabular list?: Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the knee and lower leg (S80-S89).