S02.3 vs S02.85
S02.3 (Fracture of orbital floor) compared with S02.85 (Fracture of orbit, unspecified), 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. S02.3 carries an Excludes1 note covering S02.85: “orbit NOS (S02.85)”
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. S02.85 carries an Excludes1 note covering S02.3: “orbital floor (S02.3-)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Yes, when both are documented. S02.85 carries an Excludes2 note covering S02.3: “fracture of orbital floor (S02.3-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| S02.3Fracture of orbital floor | S02.85Fracture of orbit, unspecified | |
|---|---|---|
| Billing status | Non-billable header Report instead: S02.30XA, S02.30XB, S02.30XD, S02.30XG, S02.30XK | Non-billable header Report instead: S02.85XA, S02.85XB, S02.85XD, S02.85XG, S02.85XK |
| 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 floor is a non-billable ICD-10-CM category code (S02.3). | Fracture of orbit, unspecified is a non-billable ICD-10-CM category code (S02.85). |
| 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