2026 ICD-10-CM Diagnosis Code S02.85XAFracture of orbit, unspecified, initial encounter for closed fracture

ICD-10-CM Codes›S00–T88›S00-S09›S02

ICD-10-CM S02.85XA
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

S02.85XA is a billable ICD-10-CM diagnosis code for fracture of orbit, unspecified, initial encounter for closed fracture. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 963 through 965. Coders also document this condition as closed fracture of left orbit. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Fracture of head and neck, initial encounter.

Code Identity

ICD-10-CM Code
S02.85XA
Billable Status
Yes — Valid for Submission
Code Describes
Fracture of orbit, unspecified, initial encounter for closed fracture
Short Description
Fracture of orbit, unspecified, init
Parent Code
S02.85
Fracture of orbit, unspecified

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionS00-S09Injuries to the head
CategoryS02Fracture of skull and facial bones
This CodeS02.85XAFracture of orbit, unspecified, initial encounter for closed fracture

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Closed fracture of left orbit
  • Closed fracture of right orbit
  • Complicated fracture of bone
  • Complicated fracture of orbit
  • Fracture of orbit
  • Open fracture of left orbit
  • Open fracture of right orbit

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.

CCSR INJ001
Fracture of head and neck, initial encounter
Default principal diagnosis: inpatient Yes · outpatient Yes

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.

Code History & ChangesHistory

Replacement S02.85XA replaces the following previously assigned code(s):

  • S02.80XA - Fx oth skull and facial bones, unspecified side, init
FY 2020AddedAdded to the ICD-10-CM code setEffective October 1, 2019.
FY 2021–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About S02.85XAOverview

Is S02.85XA (Fracture of orbit, unspecified) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report fracture of orbit, unspecified, initial encounter for closed fracture on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character A in S02.85XA mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for fracture of orbit, unspecified, such as an emergency visit or first evaluation.

What MS-DRG does S02.85XA group to?

When fracture of orbit, unspecified, initial encounter for closed fracture is the principal diagnosis on an inpatient stay, it groups to MS-DRG 963, 964, 965, with relative weights from 0.9405 to 2.7338 depending on complications. Higher weights mean higher Medicare reimbursement.

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.