S92.426

S92.426: Nondisplaced fracture of distal phalanx of unspecified great toe

Non-billable headerICD-10-CM

S92.426 is a non-billable header ICD-10-CM code for nondisplaced fracture of distal phalanx of unspecified great toe. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

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 S92.426

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 S92.426

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.

Code history

Unchanged in every release from FY2024 to FY2027.

Code to one of these instead S92.426

7 child codes. Green means billable.