S02.40A vs S02.40AB
S02.40A (Malar fracture, right side) compared with S02.40AB (Malar fracture, right side, initial encounter for open fracture), from the official CMS tabular data.
Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 20, 2026 · All releases and sources
Summary
These codes represent different levels of the same hierarchy: S02.40A is the non-billable header that contains S02.40AB, so only S02.40AB (or a sibling) is reported.
Registry fact- What is different?
Title wording and billing status.S02.40AB’s title adds “initial encounter for open fracture” to the wording the two share (“Malar fracture, right side”). S02.40A is a non-billable header; S02.40AB is billable.
Registry fact
- Can these codes be reported together?
Not as a pair.S02.40A is the non-billable header that contains S02.40AB. A header is not reported on a claim, so the choice is S02.40AB or a sibling that matches the documentation.
Registry fact
- Is there an Excludes1 relationship?
None.Neither entry carries an Excludes1 note that names the other code.
Official rule
- Is there an Excludes2 relationship?
None.Neither entry carries an Excludes2 note that names the other code. S02.40A carries 9 Excludes2 notes and S02.40AB carries 9 Excludes2 notes covering other codes; the side-by-side table quotes them.
Official rule
- Is one more specific?
Yes.S02.40AB is a subdivision of S02.40A in the tabular hierarchy, so it is the more specific of the two.
Registry fact
- Is one a parent or header code?
Yes.S02.40A is the non-billable header that contains S02.40AB. A header stands for the whole family beneath it and is not reported on a claim.
Registry fact
- Are there sequencing instructions?
None.Neither entry carries a Code First or Use Additional Code note that names the other.
Official rule
- Are there other coding relationships?
None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.
MedCoder-derived
Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels
Can these codes be reported together?
Not as a pair — S02.40A is not reportable. S02.40A is the non-billable category that contains S02.40AB.
A header stands for the whole family of codes beneath it and is not reported on a claim, so the choice is S02.40AB or a sibling that matches the documentation. No Excludes1/Excludes2 relationship exists between these codes in the official tabular list.
Official guidance behind these answers
Section I.B.2 — Level of Detail in Coding · applies to: S02.40A and S02.40AB
Diagnosis codes are to be used and reported at their highest number of characters available and to the highest level of specificity documented in the medical record. ICD-10-CM diagnosis codes are composed of codes with 3, 4, 5, 6 or 7 characters. Codes with three characters are included in ICD-10-CM as the heading of a category of codes that may be further subdivided by the use of fourth and/or fifth characters and/or sixth characters, which provide greater detail. A three-character code is to be used only if it is not further subdivided. A code is invalid if it has not been coded to the full number of characters required for that code, including the 7th character, if applicable.
ICD-10-CM Official Guidelines FY2027
Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum
Side by side
| S02.40AMalar fracture, right side | S02.40ABMalar fracture, right side, initial encounter for open fracture | |
|---|---|---|
| Billing status | Non-billable header Report instead: S02.40AA, S02.40AB, S02.40AD, S02.40AG, S02.40AK | 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 | Malar fracture, right side is a non-billable ICD-10-CM category code (S02.40A). | Malar fracture, right side, initial encounter for open fracture is a billable ICD-10-CM diagnosis code (S02.40AB). |
| 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 |
| Excludes2 | burns and corrosions (T20-T32) effects of foreign body in ear (T16) effects of foreign body in larynx (T17.3) effects of foreign body in mouth NOS (T18.0) effects of foreign body in nose (T17.0-T17.1) effects of foreign body in pharynx (T17.2) effects of foreign body on external eye (T15.-) frostbite (T33-T34) insect bite or sting, venomous (T63.4) | burns and corrosions (T20-T32) effects of foreign body in ear (T16) effects of foreign body in larynx (T17.3) effects of foreign body in mouth NOS (T18.0) effects of foreign body in nose (T17.0-T17.1) effects of foreign body in pharynx (T17.2) effects of foreign body on external eye (T15.-) frostbite (T33-T34) insect bite or sting, venomous (T63.4) |
| Code also | any associated intracranial injury (S06.-) for any associated infection | any associated intracranial injury (S06.-) for any associated infection |
Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.
Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources