S82.52XR vs T63.4

S82.52XR (Displaced fracture of medial malleolus of left tibia, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion) compared with T63.4 (Toxic effect of venom of other arthropods), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).

Relationship

Informational

Excludes2 relationship

S82.52XR

Displaced fracture of medial malleolus of left tibia, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion

↔

T63.4

Toxic effect of venom of other arthropods

Distinct conditions — both may be reported.

“insect bite or sting, venomous (T63.4)”

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: CMS ICD-10-CM tabular instructional notes

Can these codes be reported together?

Yes, when both are documented. S82.52XR carries an Excludes2 note covering T63.4: “insect bite or sting, venomous (T63.4)”

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

Side by side

	S82.52XRDisplaced fracture of medial malleolus of left tibia, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion	T63.4Toxic effect of venom of other arthropods
Billing status	Billable	Non-billable header
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	Displaced fracture of medial malleolus of left tibia, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion is a billable ICD-10-CM diagnosis code (S82.52R).	Toxic effect of venom of other arthropods is a non-billable ICD-10-CM category code (T63.4).
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 each code from category T63
Includes	fracture of malleolus	bite or touch of venomous animal pricked or stuck by thorn or leaf
Use additional code	—	code, if applicable, for anaphylactic shock (T78.2) code(s): for all associated manifestations of toxic effect, such as: respiratory conditions due to external agents (J60-J70)

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