ICD-10-CM Code S02.5XXK

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

Version 2020 Billable Code POA Exempt

Valid for Submission

S02.5XXK is a billable code used to specify a medical diagnosis of fracture of tooth (traumatic), subsequent encounter for fracture with nonunion. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code S02.5XXK 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:	S02.5XXK
Short Description:	Fracture of tooth (traumatic), subs for fx w nonunion
Long Description:	Fracture of tooth (traumatic), subsequent encounter for fracture with nonunion

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 S02.5XXK 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.

564 - OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC
565 - OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC
566 - OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC

Present on Admission (POA)

S02.5XXK 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 Code	POA Reason for Code	CMS will pay the CC/MCC DRG?
Y	Diagnosis was present at time of inpatient admission.	YES
N	Diagnosis was not present at time of inpatient admission.	NO
U	Documentation insufficient to determine if the condition was present at the time of inpatient admission.	NO
W	Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.	YES
1	Unreported/Not used - Exempt from POA reporting.	NO

Convert S02.5XXK to ICD-9

733.82 - Nonunion of fracture (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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