S92.525A — Nondisplaced fracture of middle phalanx of left lesser toe(s), initial encounter for closed fracture
S92.525A is a billable, specific ICD-10-CM code for nondisplaced fracture of middle phalanx of left lesser toe(s), initial encounter for closed fracture. It is valid for submission on a claim.
7th 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
Risk adjustment
S92.525A 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
S92.525A is named in 3 Medicare coverage policies — 3 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
- A57311Billing and Coding: Physical Therapy - Home Health
Related codes at this level
Codes that share S92.525. If S92.525A is not quite right, the correct code is usually one of these.
- S92.525BNondisplaced fracture of middle phalanx of left lesser toe(s), initial encounter for open fracture
- S92.525DNondisplaced fracture of middle phalanx of left lesser toe(s), subsequent encounter for fracture with routine healing
- S92.525GNondisplaced fracture of middle phalanx of left lesser toe(s), subsequent encounter for fracture with delayed healing
- S92.525KNondisplaced fracture of middle phalanx of left lesser toe(s), subsequent encounter for fracture with nonunion
- S92.525PNondisplaced fracture of middle phalanx of left lesser toe(s), subsequent encounter for fracture with malunion
- S92.525SNondisplaced fracture of middle phalanx of left lesser toe(s), sequela
Questions about S92.525A
- Is S92.525A a billable ICD-10-CM code?
- Yes. S92.525A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S92.525A 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).