2022 ICD-10-CM Code S02.40

Fracture of malar, maxillary and zygoma bones, unspecified

Version 2021

Not Valid for Submission

ICD-10:S02.40
Short Description:Fracture of malar, maxillary and zygoma bones, unspecified
Long Description:Fracture of malar, maxillary and zygoma bones, unspecified

Code Classification

  • Injury, poisoning and certain other consequences of external causes (S00–T98)
    • Injuries to the head (S00-S09)
      • Fracture of skull and facial bones (S02)

S02.40 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of fracture of malar, maxillary and zygoma bones, unspecified. The code is not specific and is NOT valid for the year 2022 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 S02.40 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.

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).

Specific Coding for Fracture of malar, maxillary and zygoma bones, unspecified

Non-specific codes like S02.40 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10 codes with a higher level of specificity when coding for fracture of malar, maxillary and zygoma bones, unspecified:

  • NON-BILLABLE CODE - S02.400 for Malar fracture, unspecified side
  • BILLABLE CODE - Use S02.400A for initial encounter for closed fracture
  • BILLABLE CODE - Use S02.400B for initial encounter for open fracture
  • BILLABLE CODE - Use S02.400D for subsequent encounter for fracture with routine healing
  • BILLABLE CODE - Use S02.400G for subsequent encounter for fracture with delayed healing
  • BILLABLE CODE - Use S02.400K for subsequent encounter for fracture with nonunion
  • BILLABLE CODE - Use S02.400S for sequela
  • NON-BILLABLE CODE - S02.401 for Maxillary fracture, unspecified side
  • BILLABLE CODE - Use S02.401A for initial encounter for closed fracture
  • BILLABLE CODE - Use S02.401B for initial encounter for open fracture
  • BILLABLE CODE - Use S02.401D for subsequent encounter for fracture with routine healing
  • BILLABLE CODE - Use S02.401G for subsequent encounter for fracture with delayed healing
  • BILLABLE CODE - Use S02.401K for subsequent encounter for fracture with nonunion
  • BILLABLE CODE - Use S02.401S for sequela
  • NON-BILLABLE CODE - S02.402 for Zygomatic fracture, unspecified side
  • BILLABLE CODE - Use S02.402A for initial encounter for closed fracture
  • BILLABLE CODE - Use S02.402B for initial encounter for open fracture
  • BILLABLE CODE - Use S02.402D for subsequent encounter for fracture with routine healing
  • BILLABLE CODE - Use S02.402G for subsequent encounter for fracture with delayed healing
  • BILLABLE CODE - Use S02.402K for subsequent encounter for fracture with nonunion
  • BILLABLE CODE - Use S02.402S for sequela
  • NON-BILLABLE CODE - S02.40A for Malar fracture, right side
  • BILLABLE CODE - Use S02.40AA for initial encounter for closed fracture
  • BILLABLE CODE - Use S02.40AB for initial encounter for open fracture
  • BILLABLE CODE - Use S02.40AD for subsequent encounter for fracture with routine healing
  • BILLABLE CODE - Use S02.40AG for subsequent encounter for fracture with delayed healing
  • BILLABLE CODE - Use S02.40AK for subsequent encounter for fracture with nonunion
  • BILLABLE CODE - Use S02.40AS for sequela
  • NON-BILLABLE CODE - S02.40B for Malar fracture, left side
  • BILLABLE CODE - Use S02.40BA for initial encounter for closed fracture
  • BILLABLE CODE - Use S02.40BB for initial encounter for open fracture
  • BILLABLE CODE - Use S02.40BD for subsequent encounter for fracture with routine healing
  • BILLABLE CODE - Use S02.40BG for subsequent encounter for fracture with delayed healing
  • BILLABLE CODE - Use S02.40BK for subsequent encounter for fracture with nonunion
  • BILLABLE CODE - Use S02.40BS for sequela
  • NON-BILLABLE CODE - S02.40C for Maxillary fracture, right side
  • BILLABLE CODE - Use S02.40CA for initial encounter for closed fracture
  • BILLABLE CODE - Use S02.40CB for initial encounter for open fracture
  • BILLABLE CODE - Use S02.40CD for subsequent encounter for fracture with routine healing
  • BILLABLE CODE - Use S02.40CG for subsequent encounter for fracture with delayed healing
  • BILLABLE CODE - Use S02.40CK for subsequent encounter for fracture with nonunion
  • BILLABLE CODE - Use S02.40CS for sequela
  • NON-BILLABLE CODE - S02.40D for Maxillary fracture, left side
  • BILLABLE CODE - Use S02.40DA for initial encounter for closed fracture
  • BILLABLE CODE - Use S02.40DB for initial encounter for open fracture
  • BILLABLE CODE - Use S02.40DD for subsequent encounter for fracture with routine healing
  • BILLABLE CODE - Use S02.40DG for subsequent encounter for fracture with delayed healing
  • BILLABLE CODE - Use S02.40DK for subsequent encounter for fracture with nonunion
  • BILLABLE CODE - Use S02.40DS for sequela
  • NON-BILLABLE CODE - S02.40E for Zygomatic fracture, right side
  • BILLABLE CODE - Use S02.40EA for initial encounter for closed fracture
  • BILLABLE CODE - Use S02.40EB for initial encounter for open fracture
  • BILLABLE CODE - Use S02.40ED for subsequent encounter for fracture with routine healing
  • BILLABLE CODE - Use S02.40EG for subsequent encounter for fracture with delayed healing
  • BILLABLE CODE - Use S02.40EK for subsequent encounter for fracture with nonunion
  • BILLABLE CODE - Use S02.40ES for sequela
  • NON-BILLABLE CODE - S02.40F for Zygomatic fracture, left side
  • BILLABLE CODE - Use S02.40FA for initial encounter for closed fracture
  • BILLABLE CODE - Use S02.40FB for initial encounter for open fracture
  • BILLABLE CODE - Use S02.40FD for subsequent encounter for fracture with routine healing
  • BILLABLE CODE - Use S02.40FG for subsequent encounter for fracture with delayed healing
  • BILLABLE CODE - Use S02.40FK for subsequent encounter for fracture with nonunion
  • BILLABLE CODE - Use S02.40FS for sequela

Information for Patients


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.

Certain diseases also lead to facial disorders. For example, nerve diseases like trigeminal neuralgia or Bell's palsy sometimes cause facial pain, spasms and trouble with eye or facial movement. Birth defects can also affect the face. They can cause underdeveloped or unusually prominent facial features or a lack of facial expression. Cleft lip and palate are a common facial birth defect.


[Learn More in MedlinePlus]

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

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]

Code History

  • 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 (First year ICD-10-CM implemented into the HIPAA code set)