Valid for Submission
S02.85XD is a billable diagnosis code used to specify a medical diagnosis of fracture of orbit, unspecified, subsequent encounter for fracture with routine healing. The code S02.85XD is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.
The ICD-10-CM code S02.85XD might also be used to specify conditions or terms like closed fracture of left orbit, closed fracture of right orbit, fracture of orbit, open fracture of left orbit or open fracture of right orbit. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
S02.85XD is a subsequent encounter code, includes a 7th character and should be used after the patient has completed active treatment for a condition like fracture of orbit unspecified for fracture with routine healing. According to ICD-10-CM Guidelines a "subsequent encounter" occurs when the patient is receiving routine care for the condition during the healing or recovery phase of treatment. Subsequent diagnosis codes are appropriate during the recovery phase, no matter how many times the patient has seen the provider for this condition. If the provider needs to adjust the patient's care plan due to a setback or other complication, the encounter becomes active again.
Unspecified diagnosis codes like S02.85XD 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.
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).
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Closed fracture of left orbit
- Closed fracture of right orbit
- Fracture of orbit
- Open fracture of left orbit
- Open fracture of right orbit
Diagnostic Related Groups - MS-DRG Mapping
Present on Admission (POA)
S0285XD replaces the following previously assigned ICD-10 code(s):