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S82.236A vs S82.236R

S82.236A (Nondisplaced oblique fracture of shaft of unspecified tibia, initial encounter for closed fracture) compared with S82.236R (Nondisplaced oblique fracture of shaft of unspecified tibia, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion), from the official CMS tabular data. S82.236A and S82.236R code the same injury at a different phase of treatment.

Can these codes be reported together?

Same injury, other encounter phase. S82.236A and S82.236R 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

S82.236ANondisplaced oblique fracture of shaft of unspecified tibia, initial encounter for closed fractureS82.236RNondisplaced oblique fracture of shaft 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 oblique fracture of shaft of unspecified tibia, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S82.236A).Nondisplaced oblique fracture of shaft of unspecified tibia, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion is a billable ICD-10-CM diagnosis code (S82.236R).
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