S02.3 — Fracture of orbital floor
S02.3 is a non-billable header ICD-10-CM code for fracture of orbital floor. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.
This code requires a 7th character
The appropriate 7th character is to be added to each code from category S02
- 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
- S
- sequela
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- orbit NOS (S02.85)
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Fracture of inferior orbital wall
Other codes that can never be billed with S02.3
These codes carry an Excludes1 note pointing at S02.3. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S02.3 alone.
- S02.85Fracture of orbit, unspecified
- S02.85XAFracture of orbit, unspecified, initial encounter for closed fracture
- S02.85XBFracture of orbit, unspecified, initial encounter for open fracture
- S02.85XDFracture of orbit, unspecified, subsequent encounter for fracture with routine healing
- S02.85XGFracture of orbit, unspecified, subsequent encounter for fracture with delayed healing
- S02.85XKFracture of orbit, unspecified, subsequent encounter for fracture with nonunion
- S02.85XSFracture of orbit, unspecified, sequela
Risk adjustment
S02.3 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.
Code to one of these instead S02.3
3 child codes. Green means billable.
Related codes at this level
Codes that share S02. If S02.3 is not quite right, the correct code is usually one of these.
- S02.0Fracture of vault of skull
- S02.1Fracture of base of skull
- S02.2Fracture of nasal bones
- S02.4Fracture of malar, maxillary and zygoma bones
- S02.5Fracture of tooth (traumatic)
- S02.6Fracture of mandible
- S02.8Fractures of other specified skull and facial bones
- S02.9Fracture of unspecified skull and facial bones
Questions about S02.3
- Is S02.3 a billable ICD-10-CM code?
- No. S02.3 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does S02.3 sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the head (S00-S09).
- What cannot be coded together with S02.3?
- S02.3 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.