S92.912A
S92.912A — Unspecified fracture of left toe(s), initial encounter for closed fracture
Billable / specific codeICD-10-CMleft
S92.912A is a billable, specific ICD-10-CM code for unspecified fracture of left 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
S92.912A 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
S92.912A 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
Related codes at this level
Codes that share S92.912. If S92.912A is not quite right, the correct code is usually one of these.
- S92.912BUnspecified fracture of left toe(s), initial encounter for open fracture
- S92.912DUnspecified fracture of left toe(s), subsequent encounter for fracture with routine healing
- S92.912GUnspecified fracture of left toe(s), subsequent encounter for fracture with delayed healing
- S92.912KUnspecified fracture of left toe(s), subsequent encounter for fracture with nonunion
- S92.912PUnspecified fracture of left toe(s), subsequent encounter for fracture with malunion
- S92.912SUnspecified fracture of left toe(s), sequela
Questions about S92.912A
- Is S92.912A a billable ICD-10-CM code?
- Yes. S92.912A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S92.912A 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).