S92.425A (Nondisplaced fracture of distal phalanx of left great toe, initial encounter for closed fracture) compared with S92.425S (Nondisplaced fracture of distal phalanx of left great toe, sequela), from the official CMS tabular data. S92.425A and S92.425S code the same injury at a different phase of treatment.
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
Same injury, other encounter phase. S92.425A and S92.425S 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.
| S92.425ANondisplaced fracture of distal phalanx of left great toe, initial encounter for closed fracture | S92.425SNondisplaced fracture of distal phalanx of left great toe, sequela | |
|---|---|---|
| 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 fracture of distal phalanx of left great toe, initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S92.425A). | Nondisplaced fracture of distal phalanx of left great toe, sequela is a billable ICD-10-CM diagnosis code (S92.425S). |
| 7th character | The appropriate 7th character is to be added to each code from category S92 | The appropriate 7th character is to be added to each code from category S92 |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources