2027 ICD-10-CM Diagnosis Code S92.811BOther fracture of right foot, initial encounter for open fracture
ICD-10-CM Codes›S00–T88›S90-S99›S92
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- 7th Character B — Initial Encounter for Open Fracture
- Not Chronic
S92.811B is a billable ICD-10-CM diagnosis code for other fracture of right foot, initial encounter for open fracture. The 7th character B means initial encounter for open fracture. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 562 through 563, 963 through 965. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 396 closely related codes. Coders also document this condition as disorder of sesamoid bone of foot. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Fracture of the lower limb (except hip), initial encounter.
Code Identity
Code Classification
Quality Payment Program MeasuresBilling
Medicare quality measures that can apply when S92.811B is part of the patient record.
Communication with the Physician or Other Clinician Managing On-Going Care Post-Fracture for Men and Women Aged 50 Years and Older
High Priority: YES
Measure Type: Process
Submission Methods: Claims, Registry
Description: Percentage of patients aged 50 years and older treated for a fracture with documentation of communication, between the physician treating the fracture and the physician or other clinician managing the patient’s on-going care, that a fracture occurred and that the patient was or should be considered for osteoporosis treatment or testing. This measure is submitted by the physician who treats the fracture and who therefore is held accountable for the communication.
Osteoporosis Management in Women Who Had a Fracture
High Priority: NO
Measure Type: Process
Submission Methods: Claims, Registry
Description: The percentage of women 50-85 years of age who suffered a fracture and who had either a bone mineral density (BMD) test or prescription for a drug to treat osteoporosis in the 180 days after the fracture.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Disorder of sesamoid bone of foot
- Fracture of sesamoid bone of foot
- Fracture of sesamoid bone of right foot
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 S92.811B: its own notes plus those printed at S92, block S90-S99, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.
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.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code to identify any retained foreign body, if applicable (Z18.-)
Notes
General instructions on how these codes are used.
- A fracture not indicated as displaced or nondisplaced should be coded to displaced
- A fracture not indicated as open or closed should be coded to closed
- 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.
- The appropriate 7th character is to be added to each code from category S92
- Ainitial encounter for closed fracture
- Binitial encounter for open fracture this code
- Dsubsequent encounter for fracture with routine healing
- Gsubsequent encounter for fracture with delayed healing
- Ksubsequent encounter for fracture with nonunion
- Psubsequent encounter for fracture with malunion
- Ssequela
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name S92.811B, its category, or a range that includes it.
Excludes1 3
These codes carry an Excludes1 note naming S92.811B: they are not reported together with it, unless the two conditions are unrelated.
- M84.3 Stress fracturetraumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-) names S92.-, which includes this code
- M84.4 Pathological fracture, not elsewhere classifiedtraumatic fracture (S12.-, S22.-, S32.-, S42.-, S52.-, S62.-, S72.-, S82.-, S92.-) names S92.-, which includes this code
- S91 Open wound of ankle, foot and toesopen fracture of ankle, foot and toes (S92.-with 7th character B) names S92, which includes this code
Excludes2 2
These codes carry an Excludes2 note naming S92.811B: its condition is not part of those codes, and both may be reported when the patient has both.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Foot Injuries and Disorders
Each of your feet has 26 bones, 33 joints, and more than 100 tendons, muscles, and ligaments. No wonder a lot of things can go wrong. Here are a few common problems:
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S92.811B to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code History & ChangesHistory
Replacement S92.811B replaces the following previously assigned code(s):
- S92.901B - Unsp fracture of right foot, init encntr for open fracture
Questions About S92.811BOverview
What is the ICD-10 code for other fracture of right foot, initial encounter for open fracture?
The ICD-10-CM code for other fracture of right foot, initial encounter for open fracture is S92.811B (sometimes written as S92811B). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is S92.811B (Other fracture of right foot) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report other fracture of right foot, initial encounter for open fracture on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character B in S92.811B mean?
The final character B means initial encounter for open fracture, in this case for the other fracture of right foot. It comes from the 7th character list in the CMS Tabular List for this category.
What MS-DRG does S92.811B group to?
When other fracture of right foot, initial encounter for open fracture is the principal diagnosis on an inpatient stay, it groups to MS-DRG 563, 964, 965, 562, 963, with relative weights from 0.8982 to 2.6361 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S92.811B a CC or MCC?
CMS lists S92.811B as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 396 closely related codes in its exclusion list.
