2024 ICD-10-CM Diagnosis Code S92.40

Unspecified fracture of great toe

ICD-10-CM Code:
S92.40
ICD-10 Code for:
Unspecified fracture of great toe
Is Billable?
Not Valid for Submission
Code Navigator:

Code Classification

  • Injury, poisoning and certain other consequences of external causes
    (S00–T88)
    • Injuries to the ankle and foot
      (S90-S99)
      • Fracture of foot and toe, except ankle
        (S92)

S92.40 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of unspecified fracture of great toe. The code is not specific and is NOT valid for the year 2024 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

Unspecified diagnosis codes like S92.40 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.

Specific Coding Applicable to Unspecified fracture of great toe

Non-specific codes like S92.40 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for unspecified fracture of great toe:

  • S92.401 for Displaced unspecified fracture of right great toe - NON-BILLABLE CODE

  • Use S92.401A for initial encounter for closed fracture - BILLABLE CODE

  • Use S92.401B for initial encounter for open fracture - BILLABLE CODE

  • Use S92.401D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S92.401G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S92.401K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S92.401P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S92.401S for sequela - BILLABLE CODE

  • S92.402 for Displaced unspecified fracture of left great toe - NON-BILLABLE CODE

  • Use S92.402A for initial encounter for closed fracture - BILLABLE CODE

  • Use S92.402B for initial encounter for open fracture - BILLABLE CODE

  • Use S92.402D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S92.402G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S92.402K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S92.402P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S92.402S for sequela - BILLABLE CODE

  • S92.403 for Displaced unspecified fracture of unspecified great toe - NON-BILLABLE CODE

  • Use S92.403A for initial encounter for closed fracture - BILLABLE CODE

  • Use S92.403B for initial encounter for open fracture - BILLABLE CODE

  • Use S92.403D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S92.403G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S92.403K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S92.403P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S92.403S for sequela - BILLABLE CODE

  • S92.404 for Nondisplaced unspecified fracture of right great toe - NON-BILLABLE CODE

  • Use S92.404A for initial encounter for closed fracture - BILLABLE CODE

  • Use S92.404B for initial encounter for open fracture - BILLABLE CODE

  • Use S92.404D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S92.404G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S92.404K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S92.404P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S92.404S for sequela - BILLABLE CODE

  • S92.405 for Nondisplaced unspecified fracture of left great toe - NON-BILLABLE CODE

  • Use S92.405A for initial encounter for closed fracture - BILLABLE CODE

  • Use S92.405B for initial encounter for open fracture - BILLABLE CODE

  • Use S92.405D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S92.405G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S92.405K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S92.405P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S92.405S for sequela - BILLABLE CODE

  • S92.406 for Nondisplaced unspecified fracture of unspecified great toe - NON-BILLABLE CODE

  • Use S92.406A for initial encounter for closed fracture - BILLABLE CODE

  • Use S92.406B for initial encounter for open fracture - BILLABLE CODE

  • Use S92.406D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S92.406G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S92.406K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S92.406P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S92.406S for sequela - BILLABLE CODE

Coding Guidelines

The principles of multiple coding of injuries should be followed in coding fractures. Fractures of specified sites are coded individually by site nd the level of detail furnished by medical record content.

A fracture not indicated as open or closed should be coded to closed. A fracture not indicated whether displaced or not displaced should be coded to displaced.

Initial vs. Subsequent Encounter for Fractures

Traumatic fractures are coded using the appropriate 7th character for initial encounter (A, B, C) for each encounter where the patient is receiving active treatment for the fracture. The appropriate 7th character for initial encounter should also be assigned for a patient who delayed seeking treatment for the fracture or nonunion.

Fractures are coded using the appropriate 7th character for subsequent care for encounters after the patient has completed active treatment of the fracture and is receiving routine care for the fracture during the healing or recovery phase.

Care for complications of surgical treatment for fracture repairs during the healing or recovery phase should be coded with the appropriate complication codes.

Care of complications of fractures, such as malunion and nonunion, should be reported with the appropriate 7th character for subsequent care with nonunion (K, M, N,) or subsequent care with malunion (P, Q, R).

Malunion/nonunion: The appropriate 7th character for initial encounter should also be assigned for a patient who delayed seeking treatment for the fracture or nonunion.

The open fracture designations in the assignment of the 7th character for fractures of the forearm, femur and lower leg, including ankle are based on the Gustilo open fracture classification. When the Gustilo classification type is not specified for an open fracture, the 7th character for open fracture type I or II should be assigned (B, E, H, M, Q).

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

Patient Education


Fractures

A fracture is a break, usually in a bone. If the broken bone punctures the skin, it is called an open or compound fracture. Fractures commonly happen because of car accidents, falls, or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the bones. Overuse can cause stress fractures, which are very small cracks in the bone.

Symptoms of a fracture are:

  • Intense pain
  • Deformity - the limb looks out of place
  • Swelling, bruising, or tenderness around the injury
  • Numbness and tingling
  • Problems moving a limb

You need to get medical care right away for any fracture. An x-ray can tell if your bone is broken. You may need to wear a cast or splint. Sometimes you need surgery to put in plates, pins or screws to keep the bone in place.


[Learn More in MedlinePlus]

Toe Injuries and Disorders

Fourteen of the 26 bones in your feet are in your toes. The toes, particularly your big toe, help you move and keep your balance. Playing sports, running, stubbing your toe, and dropping something on your foot can damage your toes. Wearing shoes that are too loose or too tight can also cause toe problems. Certain diseases, such as severe arthritis, can cause toe problems and pain. Gout often causes pain in the big toe.

Common toe problems include :

  • Corns and bunions
  • Ingrown toenails
  • Sprains and dislocations
  • Fractures (broken bones)

Treatments for toe injuries and disorders vary. They might include shoe inserts or special shoes, padding, taping, medicines, rest, and in severe cases, surgery.


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.