S92.425A
S92.425A: Nondisplaced fracture of distal phalanx of left great toe, initial encounter for closed fracture
Billable / specific codeICD-10-CMleft
S92.425A is a billable, specific ICD-10-CM code for nondisplaced fracture of distal phalanx of left great toe, initial encounter for closed fracture. It is valid for submission on a claim.
Check S92.425A with the rest of the claim: free scrubber7th character "A": initial encounter for closed 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 S92.425A
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with S92.425A
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
S92.425A is named in 3 Medicare coverage policies: 3 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
- A57311Billing and Coding: Physical Therapy - Home Health
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under S92.425
- S92.425BNondisplaced fracture of distal phalanx of left great toe, initial encounter for open fracture
- S92.425DNondisplaced fracture of distal phalanx of left great toe, subsequent encounter for fracture with routine healing
- S92.425GNondisplaced fracture of distal phalanx of left great toe, subsequent encounter for fracture with delayed healing
- S92.425KNondisplaced fracture of distal phalanx of left great toe, subsequent encounter for fracture with nonunion
- S92.425PNondisplaced fracture of distal phalanx of left great toe, subsequent encounter for fracture with malunion
- S92.425SNondisplaced fracture of distal phalanx of left great toe, sequela