S82.169S

S82.169S: Torus fracture of upper end of unspecified tibia, sequela

Billable / specific codeICD-10-CMPOA exempt

S82.169S is a billable, specific ICD-10-CM code for torus fracture of upper end of unspecified tibia, sequela. It is valid for submission on a claim.

Check S82.169S with the rest of the claim: free scrubber

7th character "S": sequela

The appropriate 7th character is to be added to all codes in subcategory S82.16

A: initial encounter for closed fracture
D: subsequent encounter for fracture with routine healing
G: subsequent encounter for fracture with delayed healing
K: subsequent encounter for fracture with nonunion
P: subsequent encounter for fracture with malunion
S: sequela

Excludes1 inherited from the categories above S82.169S

A category’s note binds every code beneath it.

Written on S82: Fracture of lower leg, including ankle

traumatic amputation of lower leg (S88.-)

Excludes2 inherited from the categories above S82.169S

Not part of this code, but both may be coded when both are present.

Written on S82.1: Fracture of upper end of tibia

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

Written on S82: Fracture of lower leg, including ankle

fracture of foot, except ankle (S92.-)
periprosthetic fracture around internal prosthetic ankle joint (M97.2)
periprosthetic fracture around internal prosthetic implant of knee joint (M97.1-)

Other codes that can never be billed with S82.169S

Their own Excludes1 notes name this code, so the conflict is not listed above.

M84.3Stress fracture
M84.4Pathological fracture, not elsewhere classified
S81Open wound of knee and lower leg

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

S82.169S is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A53064Billing and Coding: Outpatient Occupational Therapy

Code history

Unchanged in every release from FY2024 to FY2027.