S02.30XG ICD-10-CM Code: Fracture of orbital floor, unspecified side, subsequent encounter for fracture with delayed healing
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Inpatient Payment Groups (MS-DRG)
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.
- MS-DRG 559 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC (MDC 08)
- MS-DRG 560 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC (MDC 08)
- MS-DRG 561 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC (MDC 08)
A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.
Official Registry Overview & Definition
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for S02.30XG in the official ICD-10-CM tabular list.
Includes
Conditions the official ICD-10-CM tabular list includes under this code.
- injuries of ear
- injuries of eye
- injuries of face [any part]
- injuries of gum
- injuries of jaw
- injuries of oral cavity
- injuries of palate
- injuries of periocular area
- injuries of scalp
- injuries of temporomandibular joint area
- injuries of tongue
- injuries of tooth
Excludes1 — Not Coded Here
Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
- orbit NOS (S02.85) Compare S02.30XG vs S02.85 →
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- lateral orbital wall (S02.84-) Compare S02.30XG vs S02.84 →
- medial orbital wall (S02.83-) Compare S02.30XG vs S02.83 →
- orbital roof (S02.1-) Compare S02.30XG vs S02.1 →
- burns and corrosions (T20-T32) Compare S02.30XG vs T20 →
- effects of foreign body in ear (T16) Compare S02.30XG vs T16 →
- effects of foreign body in larynx (T17.3) Compare S02.30XG vs T17.3 →
- effects of foreign body in mouth NOS (T18.0) Compare S02.30XG vs T18.0 →
- effects of foreign body in nose (T17.0-T17.1) Compare S02.30XG vs T17.0 →
- effects of foreign body in pharynx (T17.2) Compare S02.30XG vs T17.2 →
- effects of foreign body on external eye (T15.-) Compare S02.30XG vs T15 →
- frostbite (T33-T34) Compare S02.30XG vs T33 →
- insect bite or sting, venomous (T63.4) Compare S02.30XG vs T63.4 →
Code Also
Additional codes that may be required to fully describe the encounter.
- any associated intracranial injury (S06.-)
- for any associated infection
Change history
- FY2017 — 2016-10-01Added to the code setFracture of orbital floor, unspecified side, subsequent encounter for fracture with delayed healingFY2017 changes
Verify Before Coding
- Billable — reportable as written.
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.
Contextual Map
Every relationship of S02.30XG in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Hierarchy
- S02.30 — Fracture of orbital floor, unspecified side [Hierarchy]
Referenced by Excludes1 notes
- S01 — Open wound of head [Excludes1](via S02.-): “open skull fracture (S02.- with 7th character B)”
- S02.85 — Fracture of orbit, unspecified [Excludes1](via S02.3.-): “orbital floor (S02.3-)”
Referenced by Excludes2 notes
- S02.1 — Fracture of base of skull [Excludes2](via S02.3.-): “orbital floor (S02.3-)”
- S02.8 — Fractures of other specified skull and facial bones [Excludes2](via S02.3.-): “fracture of orbital floor (S02.3-)”
- S02.83 — Fracture of medial orbital wall [Excludes2](via S02.3.-): “orbital floor (S02.3-)”
- S02.84 — Fracture of lateral orbital wall [Excludes2](via S02.3.-): “orbital floor (S02.3-)”
- S05 — Injury of eye and orbit [Excludes2](via S02.3.-): “orbital bone fracture (S02.1-, S02.3-, S02.8-)”
Referenced by Code First instructions
- R40.2 — Coma [Code First](via S02.-): “fracture of skull (S02.-)”
Referenced by Use Additional Code instructions
- S07 — Crushing injury of head [Use Additional Code](via S02.-): “skull fractures (S02.-)”
Referenced by Code Also instructions
- S04 — Injury of cranial nerve [Code Also](via S02.-): “skull fracture (S02.-)”
- S06 — Intracranial injury [Code Also](via S02.-): “skull fracture (S02.-)”
Clinical classification (CCSR)
- INJ038 — Fracture of head and neck, subsequent encounter [CCSR]
Potential MS-DRG
- DRG 559 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC [MS-DRG]: “AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC (MDC 08)”
- DRG 560 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC [MS-DRG]: “AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC (MDC 08)”
- DRG 561 — AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC [MS-DRG]: “AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC (MDC 08)”
Nearest codes (40)
- S02 — Fracture of skull and facial bones [Sibling]
- S02.129S — Fracture of orbital roof, unspecified side, sequela [Sibling]
- S02.19 — Other fracture of base of skull [Sibling]
- S02.19XA — Other fracture of base of skull, initial encounter for closed fracture [Sibling]
- S02.19XB — Other fracture of base of skull, initial encounter for open fracture [Sibling]
- S02.19XD — Other fracture of base of skull, subsequent encounter for fracture with routine healing [Sibling]
- S02.19XG — Other fracture of base of skull, subsequent encounter for fracture with delayed healing [Sibling]
- S02.19XK — Other fracture of base of skull, subsequent encounter for fracture with nonunion [Sibling]
- and 32 more
Change history
- FY2017 — Added to the code set [Change history]
Referenced by Other Codes
Clinical classification (AHRQ CCSR):INJ038 — Fracture of head and neck, subsequent encounter (default).
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Potential MS-DRG Relationships (FY2026)
Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.
Named in the grouper logic of 3 MS-DRGs: DRG 559 (MDC 08), DRG 560 (MDC 08), DRG 561 (MDC 08).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Official ICD-10-CM tabular notes on other codes that name S02.30XG or its code family.
2 Excludes1 notes: S01 (via S02.-), S02.85 (via S02.3.-).
5 Excludes2 notes: S02.1 (via S02.3.-), S02.8 (via S02.3.-), S02.83 (via S02.3.-), S02.84 (via S02.3.-), S05 (via S02.3.-).
1 Code First instructions: R40.2 (via S02.-).
1 Use Additional Code instructions: S07 (via S02.-).
Frequently Asked Questions (FAQ) & Clinical Guidance
Does S02.30XG require a 7th character?
Yes. The appropriate 7th character is to be added to each code from category S02.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to S02.30XG in its code family, with their registry titles.
- S02.3 — Fracture of orbital floor
- S02.30 — Fracture of orbital floor, unspecified side
- S02.30XA — Fracture of orbital floor, unspecified side, initial encounter for closed fracture
- S02.30XB — Fracture of orbital floor, unspecified side, initial encounter for open fracture
- S02.30XD — Fracture of orbital floor, unspecified side, subsequent encounter for fracture with routine healing
- S02.30XK — Fracture of orbital floor, unspecified side, subsequent encounter for fracture with nonunion
- S02.30XS — Fracture of orbital floor, unspecified side, sequela
- S02.31 — Fracture of orbital floor, right side
- S02.31XA — Fracture of orbital floor, right side, initial encounter for closed fracture
- S02.31XB — Fracture of orbital floor, right side, initial encounter for open fracture