ICD-10-CM Code S02.5XXG

Fracture of tooth (traumatic), subsequent encounter for fracture with delayed healing

Version 2020 Billable Code POA Exempt

Valid for Submission

S02.5XXG is a billable code used to specify a medical diagnosis of fracture of tooth (traumatic), subsequent encounter for fracture with delayed healing. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code S02.5XXG might also be used to specify conditions or terms like broken tooth with complication, broken tooth without complication, complicated tooth crown and root fracture, enamel and dentine fracture, fracture of crown and root of tooth, fracture of crown of tooth, enamel and dentin, with pulp exposure, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

ICD-10:S02.5XXG
Short Description:Fracture of tooth (traumatic), subs for fx w delay heal
Long Description:Fracture of tooth (traumatic), subsequent encounter for fracture with delayed healing

Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Broken tooth with complication
  • Broken tooth without complication
  • Complicated tooth crown and root fracture
  • Enamel and dentine fracture
  • Fracture of crown and root of tooth
  • Fracture of crown of tooth, enamel and dentin, with pulp exposure
  • Fracture of crown of tooth, enamel and dentin, without pulp exposure
  • Fracture of crown of tooth, enamel only
  • Fracture of cusp of tooth during masticatory loading
  • Fracture of dental root
  • Fracture of fissure of tooth
  • Fracture of migrated tooth
  • Fracture of root of tooth at bifurcation
  • Fracture of tooth
  • Horizontal fracture of apical third of root of tooth
  • Horizontal fracture of cervical third of root of tooth
  • Horizontal fracture of middle third of root of tooth
  • Horizontal fracture of tooth
  • Incomplete fracture of tooth
  • Insufficient clinical crown height due to fracture
  • Multiple root fractures
  • Open fracture of tooth
  • Periodontitis due to fracture of root of tooth
  • Tooth crown fracture
  • Uncomplicated tooth crown and root fracture
  • Uncomplicated tooth crown fracture
  • Vertical fracture of root of tooth
  • Vertical fracture of tooth extending into pulp of tooth
  • Vertical fracture of tooth without pulp involvement

Diagnostic Related Groups

The ICD-10 code S02.5XXG is grouped in the following groups for version MS-DRG V37.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC).
applicable from 10/01/2020 through 09/30/2020.

  • 559 - AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
  • 560 - AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC
  • 561 - AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC

Present on Admission (POA)

S02.5XXG is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here .

CMS POA Indicator Options and Definitions
POA Indicator CodePOA Reason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert S02.5XXG to ICD-9

  • V54.19 - Aftrce traum fx bone NEC (Approximate Flag)

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)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Information for Patients


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.


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Tooth Disorders

What are teeth?

Your teeth are made of a hard, bonelike material. There are four parts:

  • Enamel, your tooth's hard surface
  • Dentin, the hard yellow part under the enamel
  • Cementum, the hard tissue that covers the root and keeps your teeth in place
  • Pulp, the soft connective tissue in the center of your tooth. It contains nerves and blood vessels.

You need your teeth for many activities that you may take for granted. These include eating, speaking and even smiling.

What are tooth disorders?

There are many different problems that can affect your teeth, including

  • Tooth decay - damage to a tooth's surface, which can lead to cavities
  • Abscess - a pocket of pus, caused by a tooth infection
  • Impacted tooth - a tooth did not erupt (break through the gum) when it should have. It is usually wisdom teeth that are impacted, but it can sometimes happen to other teeth.
  • Misaligned teeth (malocclusion)
  • Tooth injuries such as broken or chipped teeth

What causes tooth disorders?

The causes of tooth disorders varies, depending on the problem. Sometimes the cause is not taking good care of your teeth. In other cases, you may have been born with the problem or the cause is an accident.

What are the symptoms of tooth disorders?

The symptoms can vary, depending on the problem. Some of the more common symptoms include

  • Abnormal color or shape of the tooth
  • Tooth pain
  • Worn-down teeth

How are tooth disorders diagnosed?

Your dentist will ask about your symptoms, look at your teeth, and probe them with dental instruments. In some cases, you may need dental x-rays.

What are the treatments for tooth disorders?

The treatment will depend on the problem. Some common treatments are

  • Fillings for cavities
  • Root canals for cavities or infections that affect the pulp (inside of the tooth)
  • Extractions (pulling teeth) for teeth that are impacted and causing problems or are too damaged to be fixed. You may also have a tooth or teeth pulled because of overcrowding in your mouth.

Can tooth disorders be prevented?

The main thing that you can do to prevent tooth disorders is to take good care of your teeth:

  • Brush your teeth twice a day with a fluoride toothpaste
  • Clean between your teeth every day with floss or another type of between-the-teeth cleaner
  • Limit sugary snacks and drinks
  • Don't smoke or chew tobacco
  • See your dentist or oral health professional regularly

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