S92.254B

S92.254B: Nondisplaced fracture of navicular [scaphoid] of right foot, initial encounter for open fracture

Billable / specific codeICD-10-CMright

S92.254B is a billable, specific ICD-10-CM code for nondisplaced fracture of navicular [scaphoid] of right foot, initial encounter for open fracture. It is valid for submission on a claim.

Check S92.254B with the rest of the claim: free scrubber

7th character "B": initial encounter for open fracture

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 inherited from the categories above S92.254B

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

Written on S92: Fracture of foot and toe, except ankle

fracture of ankle (S82.-)
fracture of malleolus (S82.-)
traumatic amputation of ankle and foot (S98.-)

Other codes that can never be billed with S92.254B

Their own Excludes1 notes name this code, so the conflict is not listed above.

M84.3Stress fracture
M84.4Pathological fracture, not elsewhere classified
S91Open wound of ankle, foot and toes

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

S92.254B is named in 7 Medicare coverage policies: 7 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A53058Billing and Coding: Home Health Physical Therapy
A53065Billing and Coding: Outpatient Physical Therapy
A54767Billing and Coding: Medicare Preventive Coverage for Certain Vaccines
A56900Billing and Coding: Immunizations

Code history

Unchanged in every release from FY2024 to FY2027.