S02.30XB vs S02.85
S02.30XB (Fracture of orbital floor, unspecified side, initial encounter for open fracture) 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. S02.30XB 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 S02.30XB: “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 S02.30XB: “fracture of orbital floor (S02.3-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| S02.30XBFracture of orbital floor, unspecified side, initial encounter for open fracture | S02.85Fracture of orbit, unspecified | |
|---|---|---|
| Billing status | Billable | Non-billable header |
| 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, unspecified side, initial encounter for open fracture is a billable ICD-10-CM diagnosis code (S02.30B). | 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