Is S82.61XM a billable ICD-10-CM code?

Yes. S82.61XM is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S82.61XM 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).

What cannot be coded together with S82.61XM?

S82.61XM carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S82.61XM (S82.6, S82) and apply to it just the same.

S82.61XM

S82.61XM — Displaced fracture of lateral malleolus of right fibula, subsequent encounter for open fracture type I or II with nonunion

Billable / specific codeICD-10-CMPOA exemptright

S82.61XM is a billable, specific ICD-10-CM code for displaced fracture of lateral malleolus of right fibula, subsequent encounter for open fracture type i or ii with nonunion. It is valid for submission on a claim.

7th character "M" — subsequent encounter for open fracture type I or II with nonunion

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

Excludes1 inherited from the categories above S82.61XM

These are not written on S82.61XM, but they bind it: a note on a category applies to every code beneath it. Billing S82.61XM with anything listed here is a denial.

Written on S82.6 — Fracture of lateral malleolus

pilon fracture of distal tibia (S82.87-)

Written on S82 — Fracture of lower leg, including ankle

traumatic amputation of lower leg (S88.-)

Excludes2 inherited from the categories above S82.61XM

Also inherited, and the opposite of Excludes1: these conditions are not part of S82.61XM, but a patient can have both, so you may code both.

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 S82.61XM

These codes carry an Excludes1 note pointing at S82.61XM. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S82.61XM alone.

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

Risk adjustment

S82.61XM 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

S82.61XM is named in 5 Medicare coverage policies — 5 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

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A53058Billing and Coding: Home Health Physical Therapy
A53065Billing and Coding: Outpatient Physical Therapy

Code history

S82.61XM has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share S82.61. If S82.61XM is not quite right, the correct code is usually one of these.

Questions about S82.61XM

Is S82.61XM a billable ICD-10-CM code?: Yes. S82.61XM is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S82.61XM 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).
What cannot be coded together with S82.61XM?: S82.61XM carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S82.61XM (S82.6, S82) and apply to it just the same.