S92.536S
S92.536S: Nondisplaced fracture of distal phalanx of unspecified lesser toe(s), sequela
Billable / specific codeICD-10-CMPOA exempt
S92.536S is a billable, specific ICD-10-CM code for nondisplaced fracture of distal phalanx of unspecified lesser toe(s), sequela. It is valid for submission on a claim.
Check S92.536S with the rest of the claim: free scrubber7th character "S": sequela
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 S92.536S
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with S92.536S
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
S92.536S is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A53064Billing and Coding: Outpatient Occupational Therapy
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under S92.536
- S92.536ANondisplaced fracture of distal phalanx of unspecified lesser toe(s), initial encounter for closed fracture
- S92.536BNondisplaced fracture of distal phalanx of unspecified lesser toe(s), initial encounter for open fracture
- S92.536DNondisplaced fracture of distal phalanx of unspecified lesser toe(s), subsequent encounter for fracture with routine healing
- S92.536GNondisplaced fracture of distal phalanx of unspecified lesser toe(s), subsequent encounter for fracture with delayed healing
- S92.536KNondisplaced fracture of distal phalanx of unspecified lesser toe(s), subsequent encounter for fracture with nonunion
- S92.536PNondisplaced fracture of distal phalanx of unspecified lesser toe(s), subsequent encounter for fracture with malunion