Is S92.016S a billable ICD-10-CM code?

Yes. S92.016S is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does S92.016S 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).

S92.016S

S92.016S — Nondisplaced fracture of body of unspecified calcaneus, sequela

Billable / specific codeICD-10-CMPOA exempt

S92.016S is a billable, specific ICD-10-CM code for nondisplaced fracture of body of unspecified calcaneus, sequela. It is valid for submission on a claim.

7th character "S" — sequela

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

Risk adjustment

S92.016S 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

S92.016S is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A53064Billing and Coding: Outpatient Occupational Therapy

Related codes at this level

Codes that share S92.016. If S92.016S is not quite right, the correct code is usually one of these.

Questions about S92.016S

Is S92.016S a billable ICD-10-CM code?: Yes. S92.016S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does S92.016S 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).