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
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