2026 ICD-10-CM Diagnosis Code S02.40ABMalar fracture, right side, initial encounter for open fracture
S02.40AB is a billable ICD-10-CM diagnosis code for malar fracture, right side, initial encounter for open fracture. The 7th character B reports the initial encounter for an open fracture. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 157 through 159, 963 through 965. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Fracture of head and neck, initial encounter.
Code Identity
Code Classification
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 2026, published by CMS and the National Center for Health Statistics.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
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 S02.40AB to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code History & ChangesHistory
Replacement S02.40AB replaces the following previously assigned code(s):
- S02.400B - Malar fracture unspecified, init encntr for open fracture
- S02.400B - Malar fracture, unspecified side, 7thB
Questions About S02.40ABOverview
Is S02.40AB (Malar fracture, right side) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report malar fracture, right side, initial encounter for open fracture on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character B in S02.40AB mean?
The final character B reports the initial encounter for an open fracture, in this case involving the malar fracture, right side.
What MS-DRG does S02.40AB group to?
When malar fracture, right side, initial encounter for open fracture is the principal diagnosis on an inpatient stay, it groups to MS-DRG 157, 158, 159, 963, 964, 965, with relative weights from 0.7085 to 2.7338 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of S02.40AB?
Under the General Equivalence Mappings, malar fracture, right side, initial encounter for open fracture converts to ICD-9-CM 802.5 (fx malar/maxillary-open). The mapping is approximate, so confirm the match fits the documentation.
Footnotes
[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.
