S92.512B — Displaced fracture of proximal phalanx of left lesser toe(s), initial encounter for open fracture
S92.512B is a billable, specific ICD-10-CM code for displaced fracture of proximal phalanx of left lesser toe(s), 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
Excludes2 inherited from the categories above S92.512B
Also inherited, and the opposite of Excludes1: these conditions are not part of S92.512B, but a patient can have both, so you may code both.
Other codes that can never be billed with S92.512B
These codes carry an Excludes1 note pointing at S92.512B. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S92.512B alone.
Risk adjustment
S92.512B 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
S92.512B 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
Code history
S92.512B has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share S92.512. If S92.512B is not quite right, the correct code is usually one of these.
- S92.512ADisplaced fracture of proximal phalanx of left lesser toe(s), initial encounter for closed fracture
- S92.512DDisplaced fracture of proximal phalanx of left lesser toe(s), subsequent encounter for fracture with routine healing
- S92.512GDisplaced fracture of proximal phalanx of left lesser toe(s), subsequent encounter for fracture with delayed healing
- S92.512KDisplaced fracture of proximal phalanx of left lesser toe(s), subsequent encounter for fracture with nonunion
- S92.512PDisplaced fracture of proximal phalanx of left lesser toe(s), subsequent encounter for fracture with malunion
- S92.512SDisplaced fracture of proximal phalanx of left lesser toe(s), sequela
Questions about S92.512B
- Is S92.512B a billable ICD-10-CM code?
- Yes. S92.512B is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S92.512B 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).