K03.81 vs S02.5XXG
K03.81 (Cracked tooth) compared with S02.5XXG (Fracture of tooth (traumatic), subsequent encounter for fracture with delayed healing), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. K03.81 carries an Excludes1 note covering S02.5XXG: “broken or fractured tooth due to trauma (S02.5)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
No — do not report together. S02.5XXG carries an Excludes1 note covering K03.81: “cracked tooth (nontraumatic) (K03.81)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Side by side
| K03.81Cracked tooth | S02.5XXGFracture of tooth (traumatic), subsequent encounter for fracture with delayed healing | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | K00-K95 — Diseases of the Digestive System (K00-K95) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Cracked tooth is a billable ICD-10-CM diagnosis code (K03.81). | Fracture of tooth (traumatic), subsequent encounter for fracture with delayed healing is a billable ICD-10-CM diagnosis code (S02.5G). |
| 7th character | — | The appropriate 7th character is to be added to each code from category S02 |
| Includes | — | injuries of ear injuries of eye injuries of face [any part] injuries of gum |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources