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S02.5XXA ICD-10-CM Code: Fracture of tooth (traumatic), initial encounter for closed fracture

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 157 — DENTAL AND ORAL DISEASES WITH MCC (MDC 03)
  • MS-DRG 158 — DENTAL AND ORAL DISEASES WITH CC (MDC 03)
  • MS-DRG 159 — DENTAL AND ORAL DISEASES WITHOUT CC/MCC (MDC 03)
  • MS-DRG 963 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC (MDC 24)
  • MS-DRG 964 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC (MDC 24)
  • MS-DRG 965 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC (MDC 24)

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

Fracture of tooth (traumatic), initial encounter for closed fracture is a billable ICD-10-CM diagnosis code (S02.5A).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for S02.5XXA 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

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Broken 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).

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

Frequently Compared Codes

The official Excludes notes on S02.5XXA name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.

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 S02.5XXA 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 6 MS-DRGs: DRG 157 (MDC 03), DRG 158 (MDC 03), DRG 159 (MDC 03), DRG 963 (MDC 24), DRG 964 (MDC 24), DRG 965 (MDC 24).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):INJ001 — Fracture of head and neck, initial 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 S02.5XXA 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)

  • INJ001 — Fracture of head and neck, initial encounter [CCSR]
  • DEN001 — Any dental condition including traumatic injury [CCSR]

Potential MS-DRG

  • DRG 157 — DENTAL AND ORAL DISEASES WITH MCC [MS-DRG]: “DENTAL AND ORAL DISEASES WITH MCC (MDC 03)”
  • DRG 158 — DENTAL AND ORAL DISEASES WITH CC [MS-DRG]: “DENTAL AND ORAL DISEASES WITH CC (MDC 03)”
  • DRG 159 — DENTAL AND ORAL DISEASES WITHOUT CC/MCC [MS-DRG]: “DENTAL AND ORAL DISEASES WITHOUT CC/MCC (MDC 03)”
  • DRG 963 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC (MDC 24)”
  • DRG 964 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC (MDC 24)”
  • DRG 965 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC (MDC 24)”

MDC crossing · procedures (28104)

  • MDC 03 — Diseases and Disorders of the Ear, Nose, Mouth and Throat [MDC crossing]: “Diseases and Disorders of the Ear, Nose, Mouth and Throat — 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.”
  • MDC 24 — Multiple Significant Trauma [MDC crossing]: “Multiple Significant Trauma — 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.”
  • 008F0ZZ — Division of Olfactory Nerve, Open Approach [Same-MDC procedure]: “Division of Olfactory Nerve, Open Approach — grouped in MDC 03, the procedure side of this code's crossing.” · check together
  • 008F3ZZ — Division of Olfactory Nerve, Percutaneous Approach [Same-MDC procedure]: “Division of Olfactory Nerve, Percutaneous Approach — grouped in MDC 03, the procedure side of this code's crossing.” · check together
  • 008F4ZZ — Division of Olfactory Nerve, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Division of Olfactory Nerve, Percutaneous Endoscopic Approach — grouped in MDC 03, the procedure side of this code's crossing.” · check together
  • 008G0ZZ — Division of Optic Nerve, Open Approach [Same-MDC procedure]: “Division of Optic Nerve, Open Approach — grouped in MDC 03, the procedure side of this code's crossing.” · check together
  • 008G3ZZ — Division of Optic Nerve, Percutaneous Approach [Same-MDC procedure]: “Division of Optic Nerve, Percutaneous Approach — grouped in MDC 03, the procedure side of this code's crossing.” · check together
  • and 28099 more

Nearest codes (40)

  • S02 — Fracture of skull and facial bones [Sibling]
  • S02.412B — LeFort II fracture, initial encounter for open fracture [Sibling]
  • S02.412D — LeFort II fracture, subsequent encounter for fracture with routine healing [Sibling]
  • S02.412G — LeFort II fracture, subsequent encounter for fracture with delayed healing [Sibling]
  • S02.412K — LeFort II fracture, subsequent encounter for fracture with nonunion [Sibling]
  • S02.412S — LeFort II fracture, sequela [Sibling]
  • S02.413 — LeFort III fracture [Sibling]
  • S02.413A — LeFort III fracture, initial encounter for closed fracture [Sibling]
  • and 32 more

Frequently Asked Questions (FAQ) & Clinical Guidance

Does S02.5XXA 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 S02.5XXA in its code family, with their registry titles.

  • S02.42XD — Fracture of alveolus of maxilla, subsequent encounter for fracture with routine healing
  • S02.42XG — Fracture of alveolus of maxilla, subsequent encounter for fracture with delayed healing
  • S02.42XK — Fracture of alveolus of maxilla, subsequent encounter for fracture with nonunion
  • S02.42XS — Fracture of alveolus of maxilla, sequela
  • S02.5 — Fracture of tooth (traumatic)
  • S02.5XXB — Fracture of tooth (traumatic), initial encounter for open fracture
  • S02.5XXD — Fracture of tooth (traumatic), subsequent encounter for fracture with routine healing
  • S02.5XXG — Fracture of tooth (traumatic), subsequent encounter for fracture with delayed healing
  • S02.5XXK — Fracture of tooth (traumatic), subsequent encounter for fracture with nonunion
  • S02.5XXS — Fracture of tooth (traumatic), sequela

View all codes in the S02 family