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S02.40A ICD-10-CM Code: Malar fracture, right side

Compare with another codeCheck this code on a claim

Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Coding at a Glance

7th character
Required — see the character table on this page
Tabular directives
12 inclusion terms · 9 Excludes2 · 2 code-also instructions

Not billable · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

Code alsoMay be needed with this code
  • any associated intracranial injury (S06.-)
  • for any associated infection
Excludes2Not included here; may be reported together
  • burns and corrosions (T20-T32)
  • effects of foreign body in ear (T16)
  • effects of foreign body in larynx (T17.3)
  • effects of foreign body in mouth NOS (T18.0)

+5 more in Instructions

IncludesWhat this code covers
  • injuries of ear
  • injuries of eye
  • injuries of face [any part]
  • injuries of gum

+8 more in Instructions

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for S02.40A in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on S02.40A itself; “inherited from” names the category or block whose note applies here.

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

Source: inherited from S00-S09

Excludes2 — Not Included Here

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

Source: inherited from S00-S09

Code Also

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

  • any associated intracranial injury (S06.-) inherited from S02
  • for any associated infection inherited from S00-S09

7th Character Guide

"The appropriate 7th character is to be added to each code from category S02"

  • A — initial encounter for closed fracture
  • B — initial encounter for open fracture
  • D — subsequent encounter for fracture with routine healing
  • G — subsequent encounter for fracture with delayed healing
  • K — subsequent encounter for fracture with nonunion
  • S — sequela

How the encounter character is assigned. “Initial encounter” means the patient is receiving active treatment for the condition — it is not limited to the first visit, and a different or new provider giving active treatment still assigns it. “Subsequent encounter” covers care during the healing or recovery phase after active treatment. “Sequela” is for complications or conditions that arise as a direct result of the original condition.

ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.19.a (paraphrased by MedCoder).

Variant codes in this family

S02.40AA, S02.40AB, S02.40AD, S02.40AG, S02.40AK, S02.40AS

Character meanings are CMS's official 7th-character extensions for this family, as carried in each variant code's official description; variant codes are registry rows. The explanation of how the encounter character is assigned is MedCoder editorial, distinct from the official content above it.

Coder workflow for S02.40A

MedCoder structured workflow — derived from this code’s own official record

Before you code S02.40A

  1. S02.40A is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewS02.40AA, S02.40AB, S02.40AD, S02.40AG, S02.40AK, S02.40AS

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. A 7th character is required in this family. Confirm the documented encounter: initial (active treatment), subsequent (healing or recovery phase), or sequela. S02.40A is not valid without one. “Initial” means active treatment, not the first visit (Guidelines I.C.19.a).

    See the 7th Character Guide · Guide: 7th characters: initial, subsequent, sequela →

  3. Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: right). The unspecified-side code applies only when the record states no side. Laterality is assigned from the documented side; where a bilateral code exists and both sides are documented, it is used instead of two unilateral codes (Guidelines I.B.13).

    ReviewS02.40B · left

    Guide: Laterality coding →

  4. Confirm the injury type, the anatomical site at the most specific level documented, laterality where the family codes it, and the encounter for the 7th character. Each injury is coded separately unless the classification provides a combination code, and a superficial injury is not coded when a more severe injury of the same site is documented. A fracture not documented as open or closed is coded as closed; one not documented as displaced or nondisplaced is coded as displaced. Injury chapter guidelines (Guidelines I.C.19.b, I.C.19.b.1, I.C.19.c).

    Guide: Traumatic vs pathological vs stress fracture →

Choose the right path

  1. Does the documentation support one of the more specific codes beneath S02.40A?
    Yes → Select that code and continue the checks below on its own page.
    No → S02.40A cannot be reported as written; query for the specificity its subcategory needs.

    ReviewS02.40AA, S02.40AB, S02.40AD, S02.40AG, S02.40AK, S02.40AS

  2. Is the side documented?
    Yes → Select the code for the documented side (or the bilateral code when both sides are documented and one exists).
    No → Use the unspecified-side code only when the record states no side; a query is the alternative.

    ReviewS02.40B · left

  3. Is the encounter phase documented — active treatment, healing or recovery, or a sequela?
    Yes → Assign the matching 7th character; the variant codes are in the 7th Character Guide.
    No → The code is invalid without its 7th character — query for the missing element.

Consider S02.40A. Then review the Code Also note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Anatomical site
At the most specific level the record states; a site the classification separates cannot be assumed from a procedure or a measurement.
Laterality
Right, left or bilateral as documented; unspecified only when the record states no side (Guidelines I.B.13).
Encounter type
Active treatment, healing or recovery phase, or sequela — the basis of the 7th character (Guidelines I.C.19.a).
Open or closed; displaced or nondisplaced
Defaults apply when the record is silent: closed, and displaced (Guidelines I.C.19.c).
External cause, place and activity
For the external cause codes reported with the injury or poisoning, where documented (Guidelines I.C.20.a).

Official instructions as workflow

  • Excludes2 — not part of S02.40A(9 notes)

    Coding workflow: The conditions named in this note are not included in S02.40A. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareT16, T17.3, T18.0, T17.2, T15, T63.4

    See the official tabular notes · Guidelines I.A.12.b

  • Code Also — related condition(2 notes)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    ReviewS06

    See the official tabular notes · Guidelines I.A.17

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: The patient returns during the healing or recovery phase after active treatment of the same condition.

Coding question: Which 7th character applies?

Path: Review the official 7th-character definitions for this family in the 7th Character Guide.

Reason: “Initial encounter” means active treatment, not the first visit; care during recovery takes “subsequent encounter”, and a complication arising from the original condition takes “sequela” (Guidelines I.C.19.a).

Documentation: The record documents the condition on one side only.

Coding question: Which code in this family applies?

Path: Select the sibling code for the documented side.

Reason: Laterality is assigned from the documented side; the unspecified-side code is for records that state no side (Guidelines I.B.13).

ReviewS02.40B · left

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse S02.40A with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of S02.40A — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • S02.401— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Maxillary fracture, unspecified side” takes S02.401; specificity in the record moves it back here.

    Full comparison: S02.40A vs S02.401 →

  • S02.40B— Laterality relationship (Review)

    Same condition; these differ only in which side is documented.

    The same condition on the other side; the documented side decides, and a bilateral code, where one exists, replaces the pair when both sides are documented.

    What moves you there: A documented left side moves the case to S02.40B.

    Full comparison: S02.40A vs S02.40B →

  • S02.40AA— Encounter relationship (Review)

    Same underlying diagnosis, different encounter phase.

    The same diagnosis at a different phase of care; one encounter takes one 7th character.

    What moves you there: Documentation of a initial encounter for closed fracture moves the case to S02.40AA.

    Full comparison: S02.40A vs S02.40AA →

  • S02.40AB— Encounter relationship (Review)

    Same underlying diagnosis, different encounter phase.

    The same diagnosis at a different phase of care; one encounter takes one 7th character.

    What moves you there: Documentation of a initial encounter for open fracture moves the case to S02.40AB.

    Full comparison: S02.40A vs S02.40AB →

  • T20— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of burns and corrosions adds T20; it is not part of this code and both may be reported when both are documented.

    Full comparison: S02.40A vs T20 →

  • T32— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of burns and corrosions adds T32; it is not part of this code and both may be reported when both are documented.

    Full comparison: S02.40A vs T32 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Malar fracture, right side is a non-billable ICD-10-CM category code (S02.40A). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. A 7th character applies in this family. Confirm the documented encounter matches the character assigned. See the official 7th-character definitions and this code’s variants
  2. Laterality is coded in this family. Confirm the documented side matches the code — the opposite-side siblings are in the relationships section. See the opposite-side sibling codes
  3. 2 Code Also notes — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  4. 9 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

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

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name S02.40A or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: S01 — Open wound of head (via S02.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 1 Code First instruction: R40.2 — Coma (via S02.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

Referenced by 1 Use Additional Code instruction: S07 — Crushing injury of head (via S02.-).

These codes instruct coders to additionally report this code when it applies.

Referenced by 5 Code Also instructions across 2 chapters: G96.00 — Cerebrospinal fluid leak, unspecified (via S02.-), G96.08 — Other cranial cerebrospinal fluid leak (via S02.-), G96.09 — Other spinal cerebrospinal fluid leak (via S02.-), S04 — Injury of cranial nerve (via S02.-), S06 — Intracranial injury (via S02.-).

These codes suggest coding this condition alongside when both are present.

Related Codes

Same condition, opposite side

Same category and title, differing only in which side of the body is affected.

S02.400 — Malar fracture, unspecified side (unspecified)Compare S02.40A vs S02.400 →, S02.40B — Malar fracture, left side (left)Compare S02.40A vs S02.40B →

Contextual Map

Every relationship of S02.40A 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.

Run S02.40A with these 8 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

  • S01 — Open wound of head[Excludes1](via S02.-): “open skull fracture (S02.- with 7th character B)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Referenced by Code First instructions

  • R40.2 — Coma[Code First](via S02.-): “fracture of skull (S02.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Referenced by Use Additional Code instructions

  • S07 — Crushing injury of head[Use Additional Code](via S02.-): “skull fractures (S02.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Referenced by Code Also instructions

Nearest codes (40)

Change history

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Common coding questions

MedCoder editorial

Can S02.40A be billed directly?

No. S02.40A (Malar fracture, right side) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Does S02.40A require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category S02.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 20, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "S02.40A — Malar fracture, right side." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/s02.40a-malar-fracture-right-side

Change history

  • FY2017 — October 1, 2016
    Added to the code set
    Malar fracture, right side
    FY2017 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to S02.40A in its code family, with their registry titles.

View all codes in the S02 family