S02.31XB vs S02.85

S02.31XB (Fracture of orbital floor, right 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.

Relationship

Conflict

Excludes1 conflict

S02.31XB

Fracture of orbital floor, right side, initial encounter for open fracture

↔

S02.85

Fracture of orbit, unspecified

Not coded here — these two are mutually exclusive.

“orbit NOS (S02.85)”

An Excludes1 note means the two conditions cannot occur together, so the pair should not be reported for the same encounter. The sole exception is when the conditions are documented as unrelated to each other.

Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a

Informational

Excludes2 relationship

S02.85

Fracture of orbit, unspecified

↔

S02.31XB

Fracture of orbital floor, right side, initial encounter for open fracture

Distinct conditions — both may be reported.

“fracture of orbital floor (S02.3-)”

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source: CMS ICD-10-CM tabular instructional notes

Can these codes be reported together?

No — do not report together. S02.31XB 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).

Yes, when both are documented. S02.85 carries an Excludes2 note covering S02.31XB: “fracture of orbital floor (S02.3-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

	S02.31XBFracture of orbital floor, right 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, right side, initial encounter for open fracture is a billable ICD-10-CM diagnosis code (S02.31B).	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

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Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources