Skip to main content

S02.401G ICD-10-CM Code: Maxillary fracture, 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

Maxillary fracture, unspecified side, subsequent encounter for fracture with delayed healing is a billable ICD-10-CM diagnosis code (S02.401G).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for S02.401G 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

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Code Also

Additional codes that may be required to fully describe the encounter.

  • any associated intracranial injury (S06.-)
  • for any associated infection

Indexed Clinical Terms (1)

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code.

  • Fracture, traumatic (abduction) (adduction) (separation), maxilla, maxillary (bone) (sinus) (superior) (upper jaw)

Frequently Compared Codes

The official Excludes notes on S02.401G name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

  • FY2017 — 2016-10-01
    Description revised
    Maxillary fracture, unspecified, subsequent encounter for fracture with delayed healing → Maxillary fracture, unspecified side, subsequent encounter for fracture with delayed healing
    FY2017 changes
  • FY2017 — 2016-10-01
    Short description revised
    Maxillary fracture, unsp, subs for fx w delay heal → Maxillary fracture, unspecified side, 7thG
    FY2017 changes

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Relationships & Classification

Official ICD-10-CM tabular notes on other codes that name S02.401G or its code family.

1 Excludes1 notes: S01 (via S02.-).

1 Code First instructions: R40.2 (via S02.-).

1 Use Additional Code instructions: S07 (via S02.-).

2 Code Also instructions: S04 (via S02.-), S06 (via S02.-).

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.

Clinical classification (AHRQ CCSR):INJ038 — Fracture of head and neck, subsequent encounter (default); DEN001 — Any dental condition including traumatic injury.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Contextual Map

Every relationship of S02.401G 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

  • S00-T88 — Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) (S00-T88) [Hierarchy]
  • S00-S09 — Injuries to the head [Hierarchy]

Referenced by Excludes1 notes

  • S01 — Open wound of head [Excludes1](via S02.-): “open skull fracture (S02.- with 7th character B)” · check together

Referenced by Code First instructions

Referenced by Use Additional Code instructions

  • S07 — Crushing injury of head [Use Additional Code](via S02.-): “skull fractures (S02.-)” · check together

Referenced by Code Also instructions

  • S04 — Injury of cranial nerve [Code Also](via S02.-): “skull fracture (S02.-)” · check together
  • S06 — Intracranial injury [Code Also](via S02.-): “skull fracture (S02.-)” · check together

Clinical classification (CCSR)

  • INJ038 — Fracture of head and neck, subsequent encounter [CCSR]
  • DEN001 — Any dental condition including traumatic injury [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)”

MDC crossing · procedures (18508)

  • MDC 08 — Diseases and Disorders of the Musculoskeletal System and Connective Tissue [MDC crossing]: “Diseases and Disorders of the Musculoskeletal System and Connective Tissue — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 005T0ZZ — Destruction of Spinal Meninges, Open Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T3ZZ — Destruction of Spinal Meninges, Percutaneous Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005T4ZZ — Destruction of Spinal Meninges, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Destruction of Spinal Meninges, Percutaneous Endoscopic Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0Z3 — Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord using Laser Interstitial Thermal Therapy, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • 005W0ZZ — Destruction of Cervical Spinal Cord, Open Approach [Same-MDC procedure]: “Destruction of Cervical Spinal Cord, Open Approach — grouped in MDC 08, the procedure side of this code's crossing.” · check together
  • and 18503 more

Index entries

  • Fracture, traumatic (abduction) (adduction) (separation), maxilla, maxillary (bone) (sinus) (superior) (upper jaw)[Index term]

Nearest codes (40)

  • S02 — Fracture of skull and facial bones [Sibling]
  • S02.32 — Fracture of orbital floor, left side [Sibling]
  • S02.32XA — Fracture of orbital floor, left side, initial encounter for closed fracture [Sibling]
  • S02.32XB — Fracture of orbital floor, left side, initial encounter for open fracture [Sibling]
  • S02.32XD — Fracture of orbital floor, left side, subsequent encounter for fracture with routine healing [Sibling]
  • S02.32XG — Fracture of orbital floor, left side, subsequent encounter for fracture with delayed healing [Sibling]
  • S02.32XK — Fracture of orbital floor, left side, subsequent encounter for fracture with nonunion [Sibling]
  • S02.32XS — Fracture of orbital floor, left side, sequela [Sibling]
  • and 32 more

Change history (2)

  • FY2017 — Description revised [Change history]
  • and 1 more

Frequently Asked Questions (FAQ) & Clinical Guidance

Does S02.401G 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 S02.401G in its code family, with their registry titles.

  • S02.400S — Malar fracture, unspecified side, sequela
  • S02.401 — Maxillary fracture, unspecified side
  • S02.401A — Maxillary fracture, unspecified side, initial encounter for closed fracture
  • S02.401B — Maxillary fracture, unspecified side, initial encounter for open fracture
  • S02.401D — Maxillary fracture, unspecified side, subsequent encounter for fracture with routine healing
  • S02.401K — Maxillary fracture, unspecified side, subsequent encounter for fracture with nonunion
  • S02.401S — Maxillary fracture, unspecified side, sequela
  • S02.402 — Zygomatic fracture, unspecified side
  • S02.402A — Zygomatic fracture, unspecified side, initial encounter for closed fracture
  • S02.402B — Zygomatic fracture, unspecified side, initial encounter for open fracture

View all codes in the S02 family