S02.91XB — Unspecified fracture of skull, initial encounter for open fracture
S02.91XB is a billable, specific ICD-10-CM code for unspecified fracture of skull, 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 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
Risk adjustment
S02.91XB risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 399 Major Head Injury without Loss of Consciousness0.199 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
S02.91XB is named in 3 Medicare coverage policies — 3 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
- A56612Billing and Coding: CT of the Head
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
Code history
S02.91XB 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 S02.91. If S02.91XB is not quite right, the correct code is usually one of these.
- S02.91XAUnspecified fracture of skull, initial encounter for closed fracture
- S02.91XDUnspecified fracture of skull, subsequent encounter for fracture with routine healing
- S02.91XGUnspecified fracture of skull, subsequent encounter for fracture with delayed healing
- S02.91XKUnspecified fracture of skull, subsequent encounter for fracture with nonunion
- S02.91XSUnspecified fracture of skull, sequela
Questions about S02.91XB
- Is S02.91XB a billable ICD-10-CM code?
- Yes. S02.91XB is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S02.91XB 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).