2027 ICD-10-CM Diagnosis Code S02.402SZygomatic fracture, unspecified side, sequela

ICD-10-CM Codes›S00–T88›S00-S09›S02

ICD-10-CM S02.402S
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

S02.402S is a billable ICD-10-CM diagnosis code for zygomatic fracture, unspecified side, sequela. The 7th character S marks it as a sequela code, which reports a problem that remains after the original condition has resolved. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 91 through 93. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Injury, sequela.

S02.402S no longer risk-adjusts for Medicare Advantage: it mapped to HCC 167 under the retired CMS-HCC V24 model through payment year 2025 but maps to no category in the live V28 model. It still risk-adjusts in the PACE (CMS-HCC V22) category 167, ESRD (V21) category 167, and ESRD (V24) category 167 for payment year 2027.

Code Identity

ICD-10-CM Code
S02.402S
Billable Status
Yes — Valid for Submission
Code Describes
Zygomatic fracture, unspecified side, sequela
Short Description
Zygomatic fracture, unspecified side, sequela
Same as the full description in the CMS dataset.
Parent Code
S02.402
Zygomatic fracture, unspecified side

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionS00-S09Injuries to the head
CategoryS02Fracture of skull and facial bones
This CodeS02.402SZygomatic fracture, unspecified side, sequela

Present on Admission (POA)Billing

S02.402S is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Injuries to the head (S00-S09).

Medicare Risk Adjustment (HCC)Billing

S02.402S no longer risk-adjusts for Medicare Advantage: it maps to no payment category in the live CMS-HCC V28 model, although it still risk-adjusts in the other CMS models shown below.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
Dropped in V28 see all codes that no longer risk-adjust
Prior Model (CMS-HCC V24)
HCC 167
V24 retired last contributed to a Medicare Advantage risk score in payment year 2025
Other CMS Models
PACE (CMS-HCC V22): HCC 167 · ESRD (V21): HCC 167 · ESRD (V24): HCC 167
ESRD V21 weights: 0.017 dialysis, 0.000–0.184 functioning graft · ESRD V24 weights: 0.043 dialysis, 0.000–0.239 functioning graft
Part D (RxHCC)
Not mapped
S02.402S does not risk-adjust in the RxHCC prescription drug model

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Closed fracture of orbital portion of zygomatic bone
  • Closed fracture of zygoma
  • Closed fracture of zygomatic arch
  • Closed fracture of zygomatic tripod
  • Fracture of zygoma
  • Fracture of zygomatic arch
  • Fracture of zygomatic complex
  • Open fracture of orbital portion of zygomatic bone
  • Open fracture of zygoma
  • Open fracture of zygomatic arch
  • Orbitozygomatic fracture

Coding GuidelinesGuidance

The principles of multiple coding of injuries should be followed in coding fractures. Fractures of specified sites are coded individually by site, to 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) while 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).

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).

Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, published by CMS and the National Center for Health Statistics.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to S02.402S: its own notes plus those printed at S02, block S00-S09, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From Block S00-S09 Injuries to the head applies to 1,934 codes
  • injuries of ear
  • injuries of eye
  • injuries of face [any part]
  • injuries of gum
  • injuries of jaw
  • injuries of oral cavity
  • injuries of palate
  • injuries of periocular area
  • injuries of scalp
  • injuries of temporomandibular joint area
  • injuries of tongue
  • injuries of tooth

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Block S00-S09 Injuries to the head applies to 1,934 codes
  • burns and corrosions (T20-T32)
  • effects of foreign body in ear (T16)
  • effects of foreign body in larynx (T17.3)
  • effects of foreign body in mouth NOS (T18.0)
  • effects of foreign body in nose (T17.0-T17.1)
  • effects of foreign body in pharynx (T17.2)
  • effects of foreign body on external eye (T15.-)
  • frostbite (T33-T34)
  • insect bite or sting, venomous (T63.4)
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • code to identify any retained foreign body, if applicable (Z18.-)

Code Also

A second code may be needed to fully describe the condition; the note gives no sequencing direction.

From S02 Fracture of skull and facial bones applies to 456 codes
  • any associated intracranial injury (S06.-)
From Block S00-S09 Injuries to the head applies to 1,934 codes
  • for any associated infection

Notes

General instructions on how these codes are used.

From S02 Fracture of skull and facial bones applies to 456 codes
  • A fracture not indicated as open or closed should be coded to closed
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
  • The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.

7th Character

Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.

From S02 Fracture of skull and facial bones applies to 456 codes
  • The appropriate 7th character is to be added to each code from category S02
Values for category S02 Skull, Spine and Pelvis Fracture Encounter
  • Ainitial encounter for closed fracture
  • Binitial encounter for open fracture
  • Dsubsequent encounter for fracture with routine healing
  • Gsubsequent encounter for fracture with delayed healing
  • Ksubsequent encounter for fracture with nonunion
  • Ssequela this code

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name S02.402S, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming S02.402S: they are not reported together with it, unless the two conditions are unrelated.

  • S01 Open wound of head
    open skull fracture (S02.- with 7th character B) names S02.-, which includes this code

Code First 1

These codes say to code first a condition named in the note, and S02.402S is one of the conditions named.

  • R40.2 Coma
    fracture of skull (S02.-) names S02.-, which includes this code

Use Additional Code 1

These codes say to use an additional code from the note, and S02.402S is one of the codes named.

  • S07 Crushing injury of head
    skull fractures (S02.-) names S02.-, which includes this code

Code Also 2

These codes say S02.402S may also be needed to fully describe the condition. The note gives no sequencing direction.

  • S04 Injury of cranial nerve
    skull fracture (S02.-) names S02.-, which includes this code
  • S06 Intracranial injury
    skull fracture (S02.-) names S02.-, which includes this code

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INJ073
Injury, sequela
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Zygomatic Fractures

    fractures of the zygoma.

Patient EducationClinical

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.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert S02.402S to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
905.0 Late effec skull/face fx
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About S02.402SOverview

What is the ICD-10 code for zygomatic fracture, unspecified side, sequela?

The ICD-10-CM code for zygomatic fracture, unspecified side, sequela is S02.402S (sometimes written as S02402S). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is S02.402S (Zygomatic fracture, unspecified side) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report zygomatic fracture, unspecified side, sequela on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What does the 7th character S in S02.402S mean?

The final character S makes this a sequela code: it reports a lingering problem that remains after the zygomatic fracture, unspecified side itself has resolved, not the original event.

What MS-DRG does S02.402S group to?

When zygomatic fracture, unspecified side, sequela is the principal diagnosis on an inpatient stay, it groups to MS-DRG 91, 92, 93, with relative weights from 0.7783 to 1.7050 depending on complications. Higher weights mean higher Medicare reimbursement.

Is S02.402S exempt from POA reporting?

Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for zygomatic fracture, unspecified side, sequela on inpatient claims. The code appears in the Injuries to the head (S00-S09) range of the CMS exempt list.

Does S02.402S risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage. S02.402S mapped to HCC 167 in the retired CMS-HCC V24 model, which last determined payment in 2025, but it maps to no category in the live V28 model; see all codes that no longer risk-adjust. It still risk-adjusts in the PACE (CMS-HCC V22) category 167 (Major Head Injury), ESRD (V21) category 167 (Major Head Injury), and ESRD (V24) category 167 (Major Head Injury).