S82.446A vs S82.446N
S82.446A (Nondisplaced spiral fracture of shaft of unspecified fibula, initial encounter for closed fracture) compared with S82.446N (Nondisplaced spiral fracture of shaft of unspecified fibula, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion), from the official CMS tabular data. S82.446A and S82.446N code the same injury at a different phase of treatment.
Can these codes be reported together?
Same injury, other encounter phase. S82.446A and S82.446N 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
| S82.446ANondisplaced spiral fracture of shaft of unspecified fibula, initial encounter for closed fracture | S82.446NNondisplaced spiral fracture of shaft of unspecified fibula, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion | |
|---|---|---|
| Billing status | Billable | 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 | Nondisplaced spiral fracture of shaft of unspecified fibula, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S82.446A). | Nondisplaced spiral fracture of shaft of unspecified fibula, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion is a billable ICD-10-CM diagnosis code (S82.446N). |
| 7th character | The appropriate 7th character is to be added to all codes from category S82 | The 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