S92.403S

S92.403S: Displaced unspecified fracture of unspecified great toe, sequela

Billable / specific codeICD-10-CMPOA exempt

S92.403S is a billable, specific ICD-10-CM code for displaced unspecified fracture of unspecified great toe, sequela. It is valid for submission on a claim.

Check S92.403S with the rest of the claim: free scrubber

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

Excludes2 inherited from the categories above S92.403S

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

Written on S92.4: Fracture of great toe

Physeal fracture of phalanx of toe (S99.2-)

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 S92.403S

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

S92.403S is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A53064Billing and Coding: Outpatient Occupational Therapy

Code history

Unchanged in every release from FY2024 to FY2027.