S82.264J
S82.264J — Nondisplaced segmental fracture of shaft of right tibia, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
Billable / specific codeICD-10-CMPOA exemptright
S82.264J is a billable, specific ICD-10-CM code for nondisplaced segmental fracture of shaft of right tibia, subsequent encounter for open fracture type iiia, iiib, or iiic with delayed healing. It is valid for submission on a claim.
7th character "J" — subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
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
Risk adjustment
S82.264J 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
S82.264J is named in 6 Medicare coverage policies — 6 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52465Knee Orthoses - Policy Article
- A52465Knee Orthoses - Policy Article
- A53058Billing and Coding: Home Health Physical Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
Related codes at this level
Codes that share S82.264. If S82.264J is not quite right, the correct code is usually one of these.
- S82.264ANondisplaced segmental fracture of shaft of right tibia, initial encounter for closed fracture
- S82.264BNondisplaced segmental fracture of shaft of right tibia, initial encounter for open fracture type I or II
- S82.264CNondisplaced segmental fracture of shaft of right tibia, initial encounter for open fracture type IIIA, IIIB, or IIIC
- S82.264DNondisplaced segmental fracture of shaft of right tibia, subsequent encounter for closed fracture with routine healing
- S82.264ENondisplaced segmental fracture of shaft of right tibia, subsequent encounter for open fracture type I or II with routine healing
- S82.264FNondisplaced segmental fracture of shaft of right tibia, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
- S82.264GNondisplaced segmental fracture of shaft of right tibia, subsequent encounter for closed fracture with delayed healing
- S82.264HNondisplaced segmental fracture of shaft of right tibia, subsequent encounter for open fracture type I or II with delayed healing
- S82.264KNondisplaced segmental fracture of shaft of right tibia, subsequent encounter for closed fracture with nonunion
- S82.264MNondisplaced segmental fracture of shaft of right tibia, subsequent encounter for open fracture type I or II with nonunion
- S82.264NNondisplaced segmental fracture of shaft of right tibia, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
- S82.264PNondisplaced segmental fracture of shaft of right tibia, subsequent encounter for closed fracture with malunion
- S82.264QNondisplaced segmental fracture of shaft of right tibia, subsequent encounter for open fracture type I or II with malunion
- S82.264RNondisplaced segmental fracture of shaft of right tibia, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
- S82.264SNondisplaced segmental fracture of shaft of right tibia, sequela
Questions about S82.264J
- Is S82.264J a billable ICD-10-CM code?
- Yes. S82.264J is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S82.264J 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).