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S82.146A vs S82.146R

S82.146A (Nondisplaced bicondylar fracture of unspecified tibia, initial encounter for closed fracture) compared with S82.146R (Nondisplaced bicondylar fracture of unspecified tibia, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion), from the official CMS tabular data. S82.146A and S82.146R code the same injury at a different phase of treatment.

Relationship

Review

Encounter relationship

S82.146A
Initial encounter
Nondisplaced bicondylar fracture of unspecified tibia, initial encounter for closed fracture
S82.146R
Subsequent encounter
Nondisplaced bicondylar fracture of unspecified tibia, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion

Same underlying diagnosis, different encounter phase.

The 7th character records the phase of care for the encounter being coded, so a single encounter takes one of these characters, not several. Review whether both phases belong on the same episode of care.

Source: ICD-10-CM Official Guidelines, Section I.C.19.a

Can these codes be reported together?

Same injury, other encounter phase. S82.146A and S82.146R code the same injury at a different phase of treatment, set by the 7th character.

The 7th character records the type of care given at the encounter being coded (ICD-10-CM Official Guidelines, Section I.C.19.a), so one encounter takes one of these, not both.

Side by side

S82.146ANondisplaced bicondylar fracture of unspecified tibia, initial encounter for closed fractureS82.146RNondisplaced bicondylar fracture of unspecified tibia, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
Billing statusBillableBillable
ClassificationS00-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)
DefinitionNondisplaced bicondylar fracture of unspecified tibia, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S82.146A).Nondisplaced bicondylar fracture of unspecified tibia, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion is a billable ICD-10-CM diagnosis code (S82.146R).
7th characterThe appropriate 7th character is to be added to all codes from category S82The appropriate 7th character is to be added to all codes from category S82
Includes
fracture of malleolus
fracture of malleolus

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