S92 — Fracture of foot and toe, except ankle
S92 is a non-billable header ICD-10-CM code for fracture of foot and toe, except ankle. 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 each code from category S92
- A
- initial encounter for closed fracture
- B
- initial encounter for open 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
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.
Notes
Additional guidance from the ICD-10-CM tabular list.
- A fracture not indicated as displaced or nondisplaced should be coded to displaced
- A fracture not indicated as open or closed should be coded to closed
Other codes that can never be billed with S92
These codes carry an Excludes1 note pointing at S92. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S92 alone.
Risk adjustment
S92 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 S92
8 child codes. Green means billable.
Questions about S92
- Is S92 a billable ICD-10-CM code?
- No. S92 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S92 sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the ankle and foot (S90-S99).