S99.202B — Unspecified physeal fracture of phalanx of left toe, initial encounter for open fracture
S99.202B is a billable, specific ICD-10-CM code for unspecified physeal fracture of phalanx of left toe, 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 subcategories S99.2
- 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
S99.202B 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
S99.202B is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A54767Billing and Coding: Medicare Preventive Coverage for Certain Vaccines
Related codes at this level
Codes that share S99.202. If S99.202B is not quite right, the correct code is usually one of these.
- S99.202AUnspecified physeal fracture of phalanx of left toe, initial encounter for closed fracture
- S99.202DUnspecified physeal fracture of phalanx of left toe, subsequent encounter for fracture with routine healing
- S99.202GUnspecified physeal fracture of phalanx of left toe, subsequent encounter for fracture with delayed healing
- S99.202KUnspecified physeal fracture of phalanx of left toe, subsequent encounter for fracture with nonunion
- S99.202PUnspecified physeal fracture of phalanx of left toe, subsequent encounter for fracture with malunion
- S99.202SUnspecified physeal fracture of phalanx of left toe, sequela
Questions about S99.202B
- Is S99.202B a billable ICD-10-CM code?
- Yes. S99.202B is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S99.202B 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).