S02.12 vs S02.842D
S02.12 (Fracture of orbital roof) compared with S02.842D (Fracture of lateral orbital wall, left side, subsequent encounter for fracture with routine healing), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Can these codes be reported together?
Yes, when both are documented. S02.12 carries an Excludes2 note covering S02.842D: “lateral orbital wall (S02.84-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Yes, when both are documented. S02.842D carries an Excludes2 note covering S02.12: “orbital roof (S02.12-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Yes, when both are documented. S02.842D carries an Excludes2 note covering S02.12: “fracture of orbital roof (S02.12-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| S02.12Fracture of orbital roof | S02.842DFracture of lateral orbital wall, left side, subsequent encounter for fracture with routine healing | |
|---|---|---|
| Billing status | Non-billable header Report instead: S02.121A, S02.121B, S02.121D, S02.121G, S02.121K | Billable |
| Classification | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Fracture of orbital roof is a non-billable ICD-10-CM category code (S02.12). | Fracture of lateral orbital wall, left side, subsequent encounter for fracture with routine healing is a billable ICD-10-CM diagnosis code (S02.842D). |
| 7th character | The appropriate 7th character is to be added to each code from category S02 | 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 | 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