S82.874G

S82.874G: Nondisplaced pilon fracture of right tibia, subsequent encounter for closed fracture with delayed healing

Billable / specific codeICD-10-CMPOA exemptright

S82.874G is a billable, specific ICD-10-CM code for nondisplaced pilon fracture of right tibia, subsequent encounter for closed fracture with delayed healing. It is valid for submission on a claim.

Check S82.874G with the rest of the claim: free scrubber

7th character "G": subsequent encounter for closed fracture 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

Excludes1 inherited from the categories above S82.874G

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 S82.874G

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

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 S82.874G

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

S82.874G is named in 4 Medicare coverage policies: 4 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52465Knee Orthoses - Policy Article
A53058Billing and Coding: Home Health Physical Therapy
A53065Billing and Coding: Outpatient Physical Therapy
A57311Billing and Coding: Physical Therapy - Home Health

Code history

Unchanged in every release from FY2024 to FY2027.