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S82 vs S90.441

S82 (Fracture of lower leg, including ankle) compared with S90.441 (External constriction, right great toe), 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 28, 2026 · All releases and sources

Summary

These codes can be reported together when both conditions are documented, because S82 lists S90.441 under Excludes2, which marks them as distinct conditions.

Official rule
What is different?

The conditions named.S82 is “Fracture of lower leg, including ankle”; S90.441 is “External constriction, right great toe”.

Registry fact

Can these codes be reported together?

Yes, when both are documented.S82 lists S90.441 under Excludes2: “injuries of ankle and foot, except fracture of ankle and malleolus (S90-S99)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. S82 carries 1 Excludes1 note covering other codes; the side-by-side table quotes them.

Official rule

Is there an Excludes2 relationship?

Yes.S82’s tabular entry: “injuries of ankle and foot, except fracture of ankle and malleolus (S90-S99)”. The note covers S90.441.

Official ruleGuide: Excludes1 vs Excludes2

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

Both are headers.Both are non-billable headers, and neither contains the other.

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?

Informational

Excludes2 relationship

S82
Fracture of lower leg, including ankle
↔
S90.441
External constriction, right great toe

What we found

Yes, when both are documented.S82 carries an Excludes2 note covering S90.441: “injuries of ankle and foot, except fracture of ankle and malleolus (S90-S99)”

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

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

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 / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

  • Section I.A.12.b — Excludes2 · applies to: Excludes2

    A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.

    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

Similar descriptions do not make codes interchangeable. The documentation and the official instructions decide which code applies.

Official descriptionDiffers
S82

Fracture of lower leg, including ankle

S90.441

External constriction, right great toe

StatusDiffers
S82
Non-billable header

A header is not reported on a claim; a code beneath it is.

Report instead: S82.001A, S82.001B, S82.001C, S82.001D, S82.001E

S90.441
Non-billable header

A header is not reported on a claim; a code beneath it is.

Report instead: S90.441A, S90.441D, S90.441S

Excludes1Differs
S82
  • traumatic amputation of lower leg (S88.-)
S90.441

None at this code

Excludes2Differs
S82
  • fracture of foot, except ankle (S92.-)
  • periprosthetic fracture around internal prosthetic ankle joint (M97.2)
  • periprosthetic fracture around internal prosthetic implant of knee joint (M97.1-)
  • burns and corrosions (T20-T32)
  • frostbite (T33-T34)
  • injuries of ankle and foot, except fracture of ankle and malleolus (S90-S99)
  • insect bite or sting, venomous (T63.4)
S90.441
  • burns and corrosions (T20-T32)
  • fracture of ankle and malleolus (S82.-)
  • frostbite (T33-T34)
  • insect bite or sting, venomous (T63.4)
CategoryDiffers
S82

Is itself a category

S90.441

S90 Superficial injury of ankle, foot and toes

ChapterSame for both

S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)

IncludesDiffers
S82
  • fracture of malleolus
S90.441

None at this code

7th characterDiffers
S82
  • The appropriate 7th character is to be added to all codes from category S82
S90.441
  • The appropriate 7th character is to be added to each code from category S90

No Code first, Use additional code and Code also note at either code.

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. In a row that differs, notes every code shares are dimmed.

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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