S92.911D — Unspecified fracture of right toe(s), subsequent encounter for fracture with routine healing
S92.911D is a billable, specific ICD-10-CM code for unspecified fracture of right toe(s), subsequent encounter for fracture with routine healing. It is valid for submission on a claim.
7th character "D" — subsequent encounter for fracture with routine healing
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 S92.911D
Also inherited, and the opposite of Excludes1: these conditions are not part of S92.911D, but a patient can have both, so you may code both.
Other codes that can never be billed with S92.911D
These codes carry an Excludes1 note pointing at S92.911D. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S92.911D alone.
Risk adjustment
S92.911D 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
S92.911D is named in 2 Medicare coverage policies — 2 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
Code history
S92.911D 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 S92.911. If S92.911D is not quite right, the correct code is usually one of these.
- S92.911AUnspecified fracture of right toe(s), initial encounter for closed fracture
- S92.911BUnspecified fracture of right toe(s), initial encounter for open fracture
- S92.911GUnspecified fracture of right toe(s), subsequent encounter for fracture with delayed healing
- S92.911KUnspecified fracture of right toe(s), subsequent encounter for fracture with nonunion
- S92.911PUnspecified fracture of right toe(s), subsequent encounter for fracture with malunion
- S92.911SUnspecified fracture of right toe(s), sequela
Questions about S92.911D
- Is S92.911D a billable ICD-10-CM code?
- Yes. S92.911D is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S92.911D 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).