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S02.642B ICD-10-CM Code: Fracture of ramus of left mandible, initial encounter for open 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 011 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC (MDC PRE)
  • MS-DRG 012 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC (MDC PRE)
  • MS-DRG 013 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC (MDC PRE)
  • 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.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 399 — Major Head Injury without Loss of Consciousness

Other models: CMS-HCC V22 HCC 167

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Official Registry Overview & Definition

Fracture of ramus of left mandible, initial encounter for open fracture is a billable ICD-10-CM diagnosis code (S02.642B).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for S02.642B 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

Frequently Compared Codes

The official Excludes notes on S02.642B name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

  • FY2017 — 2016-10-01
    Added to the code set
    Fracture of ramus of left mandible, initial encounter for open fracture
    FY2017 changes

Verify Before Coding

  • CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

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

Relationships & Classification

Other codes that name S02.642B 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.

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)

CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 459 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 9 MS-DRGs: DRG 011 (MDC PRE), DRG 012 (MDC PRE), DRG 013 (MDC PRE), 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.

Related Codes

Same condition, opposite side

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

S02.641B — Fracture of ramus of right mandible, initial encounter for open fracture (right)

Same injury — initial / subsequent / sequela

Same injury, coded at a different phase of treatment via the 7th character.

S02.642A — Fracture of ramus of left mandible, initial encounter for closed fracture (initial encounter), S02.642D — Fracture of ramus of left mandible, subsequent encounter for fracture with routine healing (subsequent encounter), S02.642G — Fracture of ramus of left mandible, subsequent encounter for fracture with delayed healing (subsequent encounter), S02.642K — Fracture of ramus of left mandible, subsequent encounter for fracture with nonunion (subsequent encounter), S02.642S — Fracture of ramus of left mandible, sequela (sequela)

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Major Head Injury without Loss of Consciousness) for risk-adjusted payment.

S02.640A — Fracture of ramus of mandible, unspecified side, initial encounter for closed fracture (Major Head Injury without Loss of Consciousness), S02.640B — Fracture of ramus of mandible, unspecified side, initial encounter for open fracture (Major Head Injury without Loss of Consciousness), S02.641A — Fracture of ramus of right mandible, initial encounter for closed fracture (Major Head Injury without Loss of Consciousness), S02.641B — Fracture of ramus of right mandible, initial encounter for open fracture (Major Head Injury without Loss of Consciousness), S02.642A — Fracture of ramus of left mandible, initial encounter for closed fracture (Major Head Injury without Loss of Consciousness), S02.650A — Fracture of angle of mandible, unspecified side, initial encounter for closed fracture (Major Head Injury without Loss of Consciousness), S02.650B — Fracture of angle of mandible, unspecified side, initial encounter for open fracture (Major Head Injury without Loss of Consciousness), S02.651A — Fracture of angle of right mandible, initial encounter for closed fracture (Major Head Injury without Loss of Consciousness), S02.651B — Fracture of angle of right mandible, initial encounter for open fracture (Major Head Injury without Loss of Consciousness), S02.652A — Fracture of angle of left mandible, initial encounter for closed fracture (Major Head Injury without Loss of Consciousness), +178 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Major Head Injury with Loss of Consciousness < 1 Hour or Unspecified (related risk category), Major Head Injury with Loss of Consciousness > 1 Hour (related risk category)

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Fracture of head and neck, initial encounter, Any dental condition including traumatic injury).

S02.640A — Fracture of ramus of mandible, unspecified side, initial encounter for closed fracture, S02.640B — Fracture of ramus of mandible, unspecified side, initial encounter for open fracture, S02.641A — Fracture of ramus of right mandible, initial encounter for closed fracture, S02.641B — Fracture of ramus of right mandible, initial encounter for open fracture, S02.642A — Fracture of ramus of left mandible, initial encounter for closed fracture, S02.650A — Fracture of angle of mandible, unspecified side, initial encounter for closed fracture, S02.650B — Fracture of angle of mandible, unspecified side, initial encounter for open fracture, S02.651A — Fracture of angle of right mandible, initial encounter for closed fracture, S02.651B — Fracture of angle of right mandible, initial encounter for open fracture, S02.652A — Fracture of angle of left mandible, initial encounter for closed fracture, +717 more

Lab tests where this diagnosis supports Medicare coverage

Medicare's National Coverage Determinations list this diagnosis as medical justification for these lab tests.

Blood Glucose Test (lab test), Partial Thromboplastin Time (PTT) Test (lab test), Prothrombin Time Test and INR (PT/INR) (lab test)

Contextual Map

Every relationship of S02.642B 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]

Risk adjustment (CMS-HCC)

  • HCC 399 — Major Head Injury without Loss of Consciousness [CMS-HCC]

Potential MS-DRG (9)

  • CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”
  • DRG 011 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC [MS-DRG]: “TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC (MDC PRE)”
  • DRG 012 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC [MS-DRG]: “TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC (MDC PRE)”
  • DRG 013 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC [MS-DRG]: “TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC (MDC PRE)”
  • 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)”
  • and 2 more

MDC crossing · procedures (28257)

  • Pre-MDC[MDC crossing]: “Pre-MDC — 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 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.”
  • 02HA0QZ — Insertion of Implantable Heart Assist System into Heart, Open Approach [Same-MDC procedure]: “Insertion of Implantable Heart Assist System into Heart, Open Approach — grouped in MDC PRE, the procedure side of this code's crossing.” · check together
  • 02HA0RZ — Insertion of Short-term External Heart Assist System into Heart, Open Approach [Same-MDC procedure]: “Insertion of Short-term External Heart Assist System into Heart, Open Approach — grouped in MDC PRE, the procedure side of this code's crossing.” · check together
  • 02HA3QZ — Insertion of Implantable Heart Assist System into Heart, Percutaneous Approach [Same-MDC procedure]: “Insertion of Implantable Heart Assist System into Heart, Percutaneous Approach — grouped in MDC PRE, the procedure side of this code's crossing.” · check together
  • 02HA4QZ — Insertion of Implantable Heart Assist System into Heart, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Insertion of Implantable Heart Assist System into Heart, Percutaneous Endoscopic Approach — grouped in MDC PRE, the procedure side of this code's crossing.” · check together
  • 02RA0LZ — Replacement of Heart with Biologic and Synthetic Substitute, Autoregulated Electrohydraulic, Open Approach [Same-MDC procedure]: “Replacement of Heart with Biologic and Synthetic Substitute, Autoregulated Electrohydraulic, Open Approach — grouped in MDC PRE, the procedure side of this code's crossing.” · check together
  • and 28252 more

Nearest codes (40)

  • S02 — Fracture of skull and facial bones [Sibling]
  • S02.632G — Fracture of coronoid process of left mandible, subsequent encounter for fracture with delayed healing [Sibling]
  • S02.632K — Fracture of coronoid process of left mandible, subsequent encounter for fracture with nonunion [Sibling]
  • S02.632S — Fracture of coronoid process of left mandible, sequela [Sibling]
  • S02.64 — Fracture of ramus of mandible [Sibling]
  • S02.640 — Fracture of ramus of mandible, unspecified side [Sibling]
  • S02.640A — Fracture of ramus of mandible, unspecified side, initial encounter for closed fracture [Sibling]
  • S02.640B — Fracture of ramus of mandible, unspecified side, initial encounter for open fracture [Sibling]
  • and 32 more

Change history

  • FY2017 — Added to the code set [Change history]

Frequently Asked Questions (FAQ) & Clinical Guidance

Does S02.642B 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 S02.642B in its code family, with their registry titles.

  • S02.641G — Fracture of ramus of right mandible, subsequent encounter for fracture with delayed healing
  • S02.641K — Fracture of ramus of right mandible, subsequent encounter for fracture with nonunion
  • S02.641S — Fracture of ramus of right mandible, sequela
  • S02.642 — Fracture of ramus of left mandible
  • S02.642A — Fracture of ramus of left mandible, initial encounter for closed fracture
  • S02.642D — Fracture of ramus of left mandible, subsequent encounter for fracture with routine healing
  • S02.642G — Fracture of ramus of left mandible, subsequent encounter for fracture with delayed healing
  • S02.642K — Fracture of ramus of left mandible, subsequent encounter for fracture with nonunion
  • S02.642S — Fracture of ramus of left mandible, sequela
  • S02.65 — Fracture of angle of mandible

View all codes in the S02 family