S92.421B — Displaced fracture of distal phalanx of right great toe, initial encounter for open fracture
S92.421B is a billable, specific ICD-10-CM code for displaced fracture of distal phalanx of right great toe, initial encounter for open fracture. It is valid for submission on a claim.
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
Risk adjustment
S92.421B 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
S92.421B is named in 7 Medicare coverage policies — 7 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- 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
Related codes at this level
Codes that share S92.421. If S92.421B is not quite right, the correct code is usually one of these.
- S92.421ADisplaced fracture of distal phalanx of right great toe, initial encounter for closed fracture
- S92.421DDisplaced fracture of distal phalanx of right great toe, subsequent encounter for fracture with routine healing
- S92.421GDisplaced fracture of distal phalanx of right great toe, subsequent encounter for fracture with delayed healing
- S92.421KDisplaced fracture of distal phalanx of right great toe, subsequent encounter for fracture with nonunion
- S92.421PDisplaced fracture of distal phalanx of right great toe, subsequent encounter for fracture with malunion
- S92.421SDisplaced fracture of distal phalanx of right great toe, sequela
Questions about S92.421B
- Is S92.421B a billable ICD-10-CM code?
- Yes. S92.421B is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S92.421B 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).