Is ICD-10-CM code S02 billable?

No, S02 (Fracture of skull and facial bones) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code S02 belong to?

S02 belongs to Chapter 19 of the ICD-10-CM tabular list: S00–T88 (Injury, Poisoning and Certain Other Consequences of External Causes).

S02Not billable, use a more specific code below

Fracture of skull and facial bones

In Injuries to the head (S00-S09), chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes

456 billable codes under S02: 23 are an MCC, 202 are a CC; 148 map to HCC 399 (Major Head Injury without Loss of Consciousness).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.

Instructional notes

Code also: add a code for this too, order depends on the encounter

any associated intracranial injury (S06.-)

Also applies, from Injuries to the head (S00-S09)

These notes sit on S00-S09 and apply to every code under it, including S02.

Includes: conditions that are coded here

injuries of ear
injuries of eye
injuries of face [any part]
injuries of gum
injuries of jaw
injuries of oral cavity
injuries of palate
injuries of periocular area
injuries of scalp
injuries of temporomandibular joint area
injuries of tongue
injuries of tooth

Excludes2: not included here, code separately if applicable

burns and corrosions (T20-T32)
effects of foreign body in ear (T16)
effects of foreign body in larynx (T17.3)
effects of foreign body in mouth NOS (T18.0)
effects of foreign body in nose (T17.0-T17.1)
effects of foreign body in pharynx (T17.2)
effects of foreign body on external eye (T15.-)
frostbite (T33-T34)
insect bite or sting, venomous (T63.4)

Code also: add a code for this too, order depends on the encounter

for any associated infection

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Section I.C.19.c Coding of Traumatic Fractures (page 79), covers S02
Code fractures by site; default to closed and displaced when not specified. Use initial 7th characters during active treatment and subsequent ones during healing, not aftercare Z codes; use M80 for osteoporotic fractures from minor trauma.

Codes under S02

S02 can't be used on a claim. Pick a billable code below; grey headings group them.

S02 MS-DRGs

As the principal diagnosis, the billable codes under S02 group to these 30 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 559 Aftercare, Musculoskeletal System and Connective Tissue with MCC (132 of 456 codes)
DRG 560 Aftercare, Musculoskeletal System and Connective Tissue with CC (132 of 456 codes)
DRG 561 Aftercare, Musculoskeletal System and Connective Tissue without CC/MCC (132 of 456 codes)
DRG 963 Other Multiple Significant Trauma with MCC (102 of 456 codes)
DRG 964 Other Multiple Significant Trauma with CC (102 of 456 codes)
DRG 965 Other Multiple Significant Trauma without CC/MCC (102 of 456 codes)
DRG 564 Other Musculoskeletal System and Connective Tissue Diagnoses with MCC (71 of 456 codes)
DRG 565 Other Musculoskeletal System and Connective Tissue Diagnoses with CC (71 of 456 codes)
DRG 566 Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCC (71 of 456 codes)
DRG 091 Other Disorders of Nervous System with MCC (66 of 456 codes)
DRG 092 Other Disorders of Nervous System with CC (66 of 456 codes)
DRG 093 Other Disorders of Nervous System without CC/MCC (66 of 456 codes)
DRG 082 Traumatic Stupor and Coma >1 Hour with MCC (53 of 456 codes)
DRG 083 Traumatic Stupor and Coma >1 Hour with CC (53 of 456 codes)
DRG 084 Traumatic Stupor and Coma >1 Hour without CC/MCC (53 of 456 codes)
DRG 085 Traumatic Stupor and Coma <1 Hour with MCC (53 of 456 codes)
DRG 086 Traumatic Stupor and Coma <1 Hour with CC (53 of 456 codes)
DRG 087 Traumatic Stupor and Coma <1 Hour without CC/MCC (53 of 456 codes)
DRG 157 Dental and Oral Diseases with MCC (39 of 456 codes)
DRG 158 Dental and Oral Diseases with CC (39 of 456 codes)
DRG 159 Dental and Oral Diseases without CC/MCC (39 of 456 codes)
DRG 949 Aftercare with CC/MCC (30 of 456 codes)
DRG 950 Aftercare without CC/MCC (30 of 456 codes)
DRG 922 Other Injury, Poisoning and Toxic Effect Diagnoses with MCC (10 of 456 codes)
DRG 923 Other Injury, Poisoning and Toxic Effect Diagnoses without MCC (10 of 456 codes)
DRG 124 Other Disorders of the Eye with MCC or Thrombolytic Agent (3 of 456 codes)
DRG 125 Other Disorders of the Eye without MCC (3 of 456 codes)
DRG 154 Other Ear, Nose, Mouth and Throat Diagnoses with MCC (2 of 456 codes)
DRG 155 Other Ear, Nose, Mouth and Throat Diagnoses with CC (2 of 456 codes)
DRG 156 Other Ear, Nose, Mouth and Throat Diagnoses without CC/MCC (2 of 456 codes)

Other codes that refer to S02

Notes on these codes point to S02.

R40.2 Code First: fracture of skull (S02.-)
S01 Excludes1: open skull fracture (S02.- with 7th character B)
S04 Code Also: skull fracture (S02.-)
S06 Code Also: skull fracture (S02.-)
S07 Use Additional Code: skull fractures (S02.-)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Facial Injuries and Disorders

Face injuries and disorders can cause pain and affect how you look. In severe cases, they can affect sight, speech, breathing and your ability to swallow. Fractures (broken bones), especially in the bones of your nose, cheekbone and jaw, are common facial injuries.

Fractures

A fracture is a break in a bone. Fractures are usually caused by injuries. Since they can sometimes be serious, it's important to get medical care right away if you think you have a fracture.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.